Special Investigations Unit Director jobs in Cleveland, OH

Join Cleveland Clinic Hillcrest Hospital and experience world-class healthcare at its best. Hillcrest Hospital provides state-of-the-art healthcare to all its patients. Cleveland Clinic is recognized as one of the top hospitals in the nation. Hillcrest Hospital is a proud Magnet Hospital awarded by the American Nurses Credentialing Center. This designation is the highest honor an organization can receive for professional nursing practice. 

Responsibilities:

• Ensures accuracy of system-wide master patient index through validation and capture of patient demographic data.
• Validates patient physician information and ensures accurate collection.
• Validates and captures primary, secondary and tertiary insurance coverage to ensure accurate billing.
• Identifies patients in need of financial counseling to ensure appropriate payment of services.
• Identifies services out of insurance plan or requiring referrals; may inform patient of courses of action.
• Triage appointments based on diagnosis, patient preferences and physician specialty.
• Coordinates services and provides special instructions as requested by patient, internal physicians and referring physicians.
• Performs scheduling both intra- and inter-departmentally as requested by physician orders.
• Receives orders and processes as indicated by provider and schedules according to protocol.
• Responsible for maximizing a department's allocated spaces by scheduling all procedures/surgeries.
• Enters appointment into respective programs, both routine and emergency add-on.
• Ensures accuracy of all data including appropriate CPT coding and case information (side, equipment, etc.).
• Enters all updates, correction and changes to scheduled procedures/surgeries.
• Maintains provider schedules for designated unit. Coordinates multiple physician schedules. Maintains familiarity with all appropriate scheduling function.
• Serves as liaison with admitting office regarding hospital reservations, update admission information and cancels reservations.
• Notifies patients of their arrival times per area protocols.
• Acts as a resource to all department personnel (surgeons, medical secretaries, nurses, residents, etc.) on daily activity.
• Communicates with all departments to maximize efficiency and expedite the admission process.
• Maintains designated space/unit and patient management calendars/ledgers; maintains department data based on area needs.
• Communicates with patients and their families to provide detailed instructions, directions and resources available.
• Other duties as assigned.

Education:

• High School Diploma or GED.
• Working knowledge of computerized appointment/OR scheduling systems, patient billing, insurance processing or other related office functions to coordinate patient access.
• In-depth knowledge of medical terminology and/or CPT/ICD coding preferred.
• Knowledge of Microsoft Word and Excel applications.

Certifications:

• None required.

Complexity of Work:

• Requires excellent interpersonal skills including the ability to interact successfully with all levels of personnel.
• Requires extensive exchange of verbal communication by phone and in person.
• Exceptional written and verbal communication and organizational skills are essential.
• The ability to handle multiple tasks.
• Must treat all information and data within the scope of the position with appropriate confidentiality.
• Requires the ability to work with minimal supervision.
• Must be able to work in a stressful environment and take appropriate action.
• Ability to promote and utilize a consistent problem solving methodology.
• Ability to function independently and as a team.
• Must be detail oriented, organized and able to work under stringent deadlines.

Work Experience:

• Two years related experience in an area that provides broad knowledge of medical terminology that includes patient registration, patient billing, insurance processing or appointment/OR scheduling. Or three years of customer service concierge experience.
• Proficiency in use of personal computer (PC) and general knowledge of PC based systems and software.

Physical Requirements:

• Requires frequent standing, walking and sitting for extended periods of time.
• Lifting and carrying up to 25 lbs.
• Requires manual dexterity to grasp and handle records and to operate PC computer in the course of work and navigate throughout the hospital.
• Normal or corrected vision.

Personal Protective Equipment:

• Follows standard precautions using personal protective equipment as required.