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Date: Apr 01, 2014
Location: Abu Dhabi
Facility: Cleveland Clinic Abu Dhabi
Professional Area: International Experience
Department: Accounting & Finance
This position is responsible for submitting payment requests to insurance companies and patients. It is also responsible in pursuing collection activities, posting payments against patients’ accounts and submitting follow up claims with insurance companies. This position is also responsible for performing variety of tasks including but not limited to problem-solving with patients on billing-related questions validation of contract being loaded into the application system and review and analysis of potential claim payment variances.
Duties and Responsibilities:
Perform daily billing procedures and send CCAD bills to patients and insurance companies in a timely and accurate manne
Communicate with other CCAD? stakeholders including physician offices, patient access and HIM to help identify and resolve any billing issues
Ensure appropriate review of bills? and statements before sending out to patients and insurance companies to reduce risks of denial
Keep current on local knowledge of both CCAD and UAE? insurance regulations around billing to ensure compliance to appropriate regulations
Prepare, review and send statements to patients
Review? and understand changes to healthplans, changes to insurance rules and plan benefits
Assist with the implementation or upgrade of the billing system
Participate in multi-disciplinary meetings to address discrepancies in? payment during reviews of patient accounts
Identifies and tracks and? reports on common reasons for unpaid bills and participates in process improvement work; validate new and existing contracts and reimbursement rules/logic
Solid understanding and application of posting payments against accounts receivable accounts
Will be required to review a junior biller’s work for training and quality check
Will be required to help train and mentor new billers as they join the department
Minimum of three (3) years recent experience working in a hospital or clinic business office or healthcare insurance company required
Knowledge of medical terminology and medical coding
Working knowledge of CPT, ICD-9 or 10 and DRGs and CDM
Familiarity with HCPCS, hospital and professional billing
Experience in revenue cycle start-ups would be a big plus
Knowledge of the healthcare insurance industry in the UAE and/or US preferred
Proficient with PCs, spreadsheets and other billing software applications
Strong oral and written communication skills
Ability to speak and write in English is required
Ability to speak and write in Arabic is preferred
Bachelor’s degree in Business Management, Accounting or Finance, or related field, is required
In lieu of a Bachelor’s degree, an Associate degree in? medical billing if combined with actual experience in a medical billing environment will be accepted
Certification in medical billing and? reimbursement, certification in medical coding will be given preference
Organization Wide Competency Assessment Requirements:
All employees will embrace the CCAD mission, vision and values and be responsible for adhering to the core values of the institution, including: Patient’s First, Collaboration, Mutual Respect, Quality, Patient Safety, Integrity, Cultural Sensitivity and Compassion.
All employees are also expected to meet the standards of performance outlined in the Organization Wide Competencies listed below as applied to the position.
Customer Service Orientation includes attitude, behavior, interpersonal skill and problem solving that enable an employee to respond to internal and external customer needs and expectations in a positive manner. Adaptability including teamwork, flexibility needed to fulfill job responsibilities, adapting to changes in work environment and accepting supervisory feedback. Efficiency and Effectiveness includes quantity and quality of desired work, as well as organization skills necessary to perform successfully. Essential Job Requirements includes adherence to all relevant policies, procedures and guidelines affecting the work environment, as well as maintenance of required competencies and communication skills. Managerial Responsibilities includes overall accountability for assigned work group relative to operational goals, personnel requirements and budgetary constraints.
The responsibilities described on this job description are intended to describe the general nature and level of work being performed by people assigned to this job. These statements are not intended to be exhaustive of all responsibilities, duties, knowledge, skills and abilities required of employees in the position.
Final determination of a candidate’s qualifications and eligibility to perform the job is at the sole discretion and judgment of the institute/department executive leadership.