Coding and Reimbursement Director

Join the Cleveland Clinic team where you will work alongside passionate caregivers and make a lasting, meaningful impact on patient care. Here, you will receive endless support and appreciation while building a rewarding career with one of the most respected healthcare organizations in the world.  

As the Director of Coding and Reimbursement, you will oversee the vision, strategy and operations of Technical Coding Services, Audit, Education and/or Denials across the Cleveland Clinic enterprise. In this role, you will ensure accurate and compliant coding and charge capture for acute care, ambulatory offices and/or physician offices while partnering with Clinical Documentation Integrity (CDI) for accurate documentation.  You will serve as a liaison to various departments, physicians and Allied Health professionals and collaborate with other revenue cycle and clinical leaders to execute enterprise-wide initiatives and goals. Ultimately, your work in the office helps enhance patient support and allow caregivers to continue serving our communities every day. 

Candidates being considered reside in Ohio, Florida or Nevada. The caregiver will work remotely from 8:00AM - 5:00PM.

A caregiver who excels in this role will:  

• Establish and drive strategy, execution of initiatives, program goals and objectives. 
• Monitor performance, issues and risks. 
• Routinely collaborate with Clinical Documentation Improvement (CDI) work group on accurate documentation and coding to improve quality outcomes and foster accurate reimbursement (i.e. patient safety indicators (PSIs), hospital acquired conditions (HACs), diagnoses present on admission (POA), complications and comorbid conditions, risk adjustment models, clarification queries and education). 
• Develop and maintain standardized practices, processes, metrics, policies and procedures and guidelines across the enterprise to reduce front-end issues and ensure accurate reimbursement and patient satisfaction. 
• Serve as liaison to Institutes and Market leaders regarding technical and/or professional coding, reimbursement and customer service-related issues. 
• Develop training programs for coders, medical staff and ancillary personnel.  
• Develop management reporting systems to ensure accurate and timely reporting of goals and results. 
• Oversee and monitor resolution of patient and insurance inquiries and the coding compliance program, including conducting and overseeing coding audit efforts, reporting non-compliance issues detected and collaborating with key stakeholders on action plans. 
• Monitor changes in regulatory coding, compliance with documentation guidelines and testing compliance with regulations. 
• Direct technology optimization and automation solution initiatives, including initiating, evaluating and implementing in collaboration with ITD, providers and other success partners. 

Minimum qualifications for the ideal future caregiver include:  

• Bachelor’s Degree and eight years of relevant experience OR High School Diploma/GED with 13 years of experience 
• Registered Health Information Administrator certification (RHIA), Registered Health Information Technician certification (RHIT), Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) Certifications through the American Health Information Management Association is required.
• Advanced skills in Microsoft Office or Client 365 and MS Teams 
• Demonstrated team, leadership, organizational, financial management and problem-solving skills 

Preferred qualifications for the ideal future caregiver include:  

• Master’s Degree 

Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link and see how we’re dedicated to providing what matters most to you: https://jobs.clevelandclinic.org/benefits-2/      

Physical Requirements:

• Ability to communicate and exchange accurate information. 
• Ability to perform work in a stationary position for extended periods.  
• Ability to work with physical records or operate a computer or other office equipment.  
• In some locations, ability to travel throughout the hospital system.  
• In some locations ability to move up to 25 lbs.

Personal Protective Equipment:

• Follows standard precautions using personal protective equipment (PPE) as required.

Pay Range

Minimum hourly: $53.90

Maximum hourly: $82.19

The pay range displayed on this job posting reflects the anticipated range for new hires. While the pay range is displayed as an hourly rate, Cleveland Clinic recruiters will clarify whether the compensation is hourly or salary. A successful candidate's actual compensation will be determined after taking factors into consideration such as the candidate's work history, experience, skill set, and education. This is not inclusive of the value of Cleveland Clinic's benefits package, which includes among other benefits, healthcare/dental/vision and retirement.