Location: MetroHealth Old Brooklyn Campus

Biweekly Hours: 80.00

Shift: 8:00 - 5:00

The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it. Founded in 1837, Cuyahoga County’s safety-net health system operates four hospitals, four emergency departments and more than 20 health centers.

Summary: 

Summary:
Responsible for supervising the day to day activities for the collection and resolution of outstanding healthcare claims that may include hospital, skilled, professional and/or dental claims in an efficient and effective manner.   This needs to be done in an accurate and timely manner in compliance with rules promulgated by the Office of Inspector General (OIG) as well as any payer specific rules and regulations governed by contractual terms.  Serves as a liaison with Medical Operations, Compliance Department, Information Services, and other internal departments relative to the communication of rules, requirements and general business needs.  Monitors and communicates with external agencies including  contracted and governmental payer program changes and communicates noted and/or proposed billing changes to PFS Management.   Supervises assigned personnel.  Upholds the standards of the system-wide customer service program.

Qualifications:

Other information:


Required:
Bachelors degree in Accounting, Business or Health focused major In lieu of degree requirement, will consider five years of work experience in a physician billing office or hospital setting Two years supervisory experience or a proven record of ability to supervise a staff involved in complex billing functions Knowledge of managed care plans and understanding of capitation Computerized billing system experience Comprehensive understanding of centers for Medicare and Medicaid services (CMS) billing practices and health care issues affecting billing and reimbursement Excellent verbal and written communication skills Strong analytical skills and adept problem solving ability Successful completion of Certified Revenue Cycle Certification obtained within one year of employment

Preferred:
Five years experience with CPT-4 and ICD-9 coding with emphasis in physician reimbursement or hospital technical reimbursement Certified Professional Coder certification Proficiency with spreadsheet and word processing software Ten-key proficiency

Physical Demands: