Senior Revenue Cycle Precert Specialist Ophthalmology
2 weeks ago
Position SummaryAs an essential member of the Revenue Cycle team, Senior Pre-cert Specialists ensure authorizations for outpatient testing, ambulatory and inpatient services are obtained before services are rendered. The successful completion of tasks performed by this position, directly impacts denials and reimbursement from third party payers. Senior Pre-cert Specialists are skilled in patient/physician relations, registration, scheduling, and precertificationEssential FunctionsVerifies and pre-certifies inpatient and outpatient services to ensure appropriate reimbursement from third party payers, government payers and state agenciesMastery of skills relating to insurance coverage, benefits, rules & regulations and allocation of plans accurate information and fulfillment of requirements resulting in expected payment for servicesVerifies and allocates insurance plans utilizing electronic eligibility tools, phone calls payer, accesses web portals and initiates appropriate action for services including non-covered and out-of-network insurance servicesSubmits timely electronic and verbal notifications and clinical documentation in accordance with contractual requirements and payer guidelines; coordinates with operations and clinical counterparts to obtain and submit necessary information and documentationCommunicates potential issues and follows GM-98, Service with Authorization guidelines to notify providers of pending authorizations/denials and peer to peer requests; escalates encounters per policyEffectively communicates utilizing telephone, emails, or correspondence for internal and external customers; understand when and how to escalate cases that require operations and leadership attention to initiate appropriate actionMaintains up-to-date knowledge of computer applications, insurance/government regulations, managed care guidelines and Revenue Cycle policies/procedures used within the department.Preceptor for new hires and provides necessary training at the direction of department leadershipParticipates in enterprise special projects as neededLeads work flow and process improvement project initiativesProvides feedback, suggestions and process improvement recommendations to managementScans and retrieves appropriate related documents in scanning applicationsAttends and participates in corporate and local team meetings and maintains patient / physician confidentiality.Ensures compliance with department productivity and quality standardsAdditional ResponsibilitiesLeads departments meetings as neededRequired For All JobsPerforms other duties as assigned.Complies with all policies and standards.For specific duties and responsibilities, refer to documentation provided by the department during orientation.Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.Qualifications:QualificationsEducationHigh School Equivalent / GED Required Work Experience3+ years experience in hospital Revenue Cycle/healthcare, working with insurance companies/third-party payers or related experience Required and Experience with clinical applications Preferred Knowledge, Skills, & Abilities Knowledge of managed care insurance requirements is essential. Required Notable client service, communication and relationship building skills. Required Ability to function independently and as a team player in a fast-paced environment. Required Must have strong written and verbal communication skills. Required Professional demeanor Required Detail-oriented and organized, with good analytical and problem solving ability Required Demonstrated ability to use PCs, Microsoft Office suite, and general office equipment (i.e. printers, copy machine, multi-line phone, FAX machine, etc.) Required Physical DemandsStanding Occasionally Walking Occasionally Sitting Constantly Lifting Rarely 20 lbs Carrying Rarely 20 lbs Pushing Rarely 20 lbs Pulling Rarely 20 lbs Climbing Rarely 20 lbs Balancing Rarely Stooping Rarely Kneeling Rarely Crouching Rarely Crawling Rarely Reaching Rarely Handling Occasionally Grasping Occasionally Feeling Rarely Talking Constantly Hearing Constantly Repetitive Motions Frequently Eye/Hand/Foot Coordination Frequently
-
Revenue Cycle Specialist
11 hours ago
Cleveland, United States Staffing Solutions Enterprises Full timePosition Summary: The Revenue Cycle Specialist will provide administrative support to the Revenue Cycle Department in various tasks that impact the agency finances. This position is responsible for obtaining eligibility information and ensuring that the most updated verification is entered into the agency's practice management software. Salary: $43K Minimum...
-
Revenue Cycle Specialist II, Emergency Medicine
2 weeks ago
Cleveland, United States University Hospitals Full timeFacilitates effective tracking of all patients presenting to the Adult ED and entry of technical billing for those patients seen. (80%) Competency 1 Communicates effectively with Adult ED Management, staff, and physicians. (20%) Competency 2 Accordin Specialist, Medicine, Revenue, Cycle, Emergency, Healthcare, Skills
-
Revenue Cycle Manager
7 days ago
Cleveland, United States Cleveland Clinic Full timeThe position is open to remote in Ohio, Florida and NevadaJoin the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support...
-
Revenue Specialist
1 day ago
Cleveland, United States Staffing Solutions Enterprises Full timePosition Summary:The Revenue Cycle Specialist will provide administrative support to the Revenue Cycle Department in various tasks that impact the agency finances. This position is responsible for obtaining eligibility information and ensuring that the most updated verification is entered into the agency’s practice management software. Salary: $43KMinimum...
-
Revenue Specialist
23 hours ago
Cleveland, United States Staffing Solutions Enterprises Full timePosition Summary:The Revenue Cycle Specialist will provide administrative support to the Revenue Cycle Department in various tasks that impact the agency finances. This position is responsible for obtaining eligibility information and ensuring that the most updated verification is entered into the agency’s practice management software. Salary: $43KMinimum...
-
Receiving Specialist
6 days ago
Cleveland, United States Cycle Gear Full timeJob DescriptionJob DescriptionCompany DescriptionTotal compensation: $14.00 - $15.00 / hour Comoto Holdings is America’s largest and fastest-growing omnichannel platform in the powersports aftermarket-products industry; dedicated to advancing the experience of powersports enthusiasts across the globe. Comoto’s brands, RevZilla, Cycle Gear, J&P Cycles,...
-
Ophthalmology
7 days ago
Cleveland, United States Metro Health Full timeThe MetroHealth System, a major teaching affiliate of Case Western Reserve University School of Medicine, is seeking Ophthalmologists to join our team. The qualified candidates will join an established academic faculty practice and will be involved in resident students training. Clinical facilities include technical support staff and state of the art...
-
Ophthalmology
6 days ago
CLEVELAND, United States MetroHealth Full timeThe MetroHealth System, a major teaching affiliate of Case Western Reserve University School of Medicine, is seeking Ophthalmologists to join our team. The qualified candidates will join an established academic faculty practice and will be involved in resident students training. Clinical facilities include technical support staff and state of the art...
-
Cleveland, United States Cleveland Clinic Full timeJoin the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the...
-
Cleveland, United States RecruitWell Full timeCleveland, Ohio, Area, Ophthalmology OpportunitiesClinical Role:Do you know someone that might be a good fit for this position? Please ask about our generous referral fees!Permanent job openingSeeking board certified or truly board eligible ophthalmologistsCornea specialist, retina specialist, and oculoplastics specialist opportunities availableMultiple...
-
Cleveland, United States RecruitWell LLC Full timeCleveland, Ohio, Area, Ophthalmology Opportunities Clinical Role: Do you know someone that might be a good fit for this position? Please ask about our generous referral fees! Permanent job opening Seeking board certified or truly board eligible ophthalmologists Cornea specialist, retina specialist, and oculoplastics specialist opportunities available...
-
Cleveland, OH, United States RecruitWell Full timeCleveland, Ohio, Area, Ophthalmology Opportunities Clinical Role: Do you know someone that might be a good fit for this position? Please ask about our generous referral fees! Permanent job opening Seeking board certified or truly board eligible ophthalmologists Cornea specialist, retina specialist, and oculoplastics specialist opportunities available ...
-
Senior Tax Specialist
2 days ago
Cleveland, United States Hantz Group Full timeJob DescriptionJob Description Hantz Group Senior Tax Planning SpecialistHantz Group is a Michigan-based financial company that works with individuals and businesses to help them achieve their financial goals. We are a Family Office that manages over $11B+ of assets, has 20+ offices and over 600 employees. We offer a multitude of services tailored to each...
-
Senior Tax Specialist
5 days ago
Cleveland, United States Hantz Group Full timeJob DescriptionJob Description Hantz Group Senior Tax Planning SpecialistHantz Group is a Michigan-based financial company that works with individuals and businesses to help them achieve their financial goals. We are a Family Office that manages over $11B+ of assets, has 20+ offices and over 600 employees. We offer a multitude of services tailored to each...
-
Revenue Cycle Specialist II, Emergency Medicine
2 weeks ago
Cleveland, United States University Hospitals Full timeEssential Functions Facilitates effective tracking of all patients presenting to the Adult ED and entry of technical billing for those patients seen. (80%) Competency 1 Communicates effectively with Adult ED Management, staff, and physicians. (20%) Competency 2 According to departmental guidelines, maintains patient record and all department logs (written...
-
Oculoplastic Specialist
6 days ago
CLEVELAND, United States MetroHealth Full time**The MetroHealth System, a major teaching affiliate of Case Western Reserve University School of Medicine, is seeking Ophthalmologists to join our team. The qualified candidates will join an established academic faculty practice and will be involved in resident students training. Clinical facilities include technical support staff and state of the art...
-
Senior Cybersecurity Specialist
6 days ago
Cleveland, United States Cleveland Clinic Full timeCleveland Clinic Senior Cybersecurity Specialist Cleveland , Ohio Apply Now A Senior Cybersecurity Specialist in Endpoint Protection Cybersecurity is responsible for designing, implementing, and managing endpoint security solutions to protect devices such as computers, mobile devices, and servers. They monitor for security breaches, respond to incidents, and...
-
Oculoplastic Specialist
7 days ago
Cleveland, United States The MetroHealth System Full timeThe MetroHealth System, a major teaching affiliate of Case Western Reserve University School ofMedicine, is seeking Ophthalmologists to join our team. The qualified candidates will join an establishedacademic faculty practice and will be involved in resident students training. Clinical facilities includetechnical support staff and state of the art clinical...
-
Senior Cybersecurity Specialist
5 days ago
Cleveland, United States Cleveland Clinic Full timeA Senior Cybersecurity Specialist in Endpoint Protection Cybersecurity is responsible for designing, implementing, and managing endpoint security solutions to protect devices such as computers, mobile devices, and servers. They monitor for security breaches, respond to incidents, and conduct forensic analysis to mitigate risks. This role involves developing...
-
Senior Financial Analyst I
6 days ago
Cleveland, United States Cleveland Clinic Full timeCleveland Clinic Senior Financial Analyst I Cleveland , Ohio Apply Now Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of...
