Job Description

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.

We all have the power to help, heal and change lives \xe2\x80\x94 beginning with our own. That\xe2\x80\x99s the power of the Cleveland Clinic Health System team, and The Power of Every One.

Job Summary

Salary: \xc2\xa355,000 - \xc2\xa365,000

Hours: Monday to Friday, 9am to 5pm - hybrid

Location: 40 Grosvenor Place, London, SW1X 7AW

Contract: Permanent

Who are we?

Cleveland Clinic is one of the leading providers of specialised medical care in the world, focused on providing clinical excellence and superior patient outcomes for almost 6 million patient visits per year across more than 200 locations. We employ over 65,000 caregivers worldwide and continue to drive innovation in healthcare.

We opened our first healthcare facility in London in 2021 and our state-of-the art 184 bed hospital in 2022. With over 100 years of history, our \xe2\x80\x9cPatients First\xe2\x80\x9d philosophy will be at the heart of Cleveland Clinic London and the goal of our team is to create an environment that continues to delivers world-class clinical care.

What are we looking for?

We are looking for a Revenue Integrity Lead to report to the Revenue Assurance Manager at Cleveland Clinic London (CCL) and assist in the management of all Epic Charge description master files, consultant fee schedules, Insurer fee schedules and other Revenue Cycle operations to ensure alignment with the mission, values and objectives of the organization.

The role will act as a technical and analytical resource for team members, coordinating and providing orientation and ongoing education. It will collaborate with the Finance and Commercial departments in establishing and implementing pricing methodology and will work to ensure transparent and fair pricing initiatives are supported.

What will your duties include?

With the Revenue Assurance Manager, develops departmental goals, plans and standards consistent with the clinical, administrative, legal and ethical requirements/objectives of the organisation

Coordinates and directs internal/external Revenue Cycle audits

Demonstrates broad knowledge of applicable statutory, regulatory (GDPR) and administrative requirements relative to departmental operations and ensure compliance with the same

Responsible for Chargemaster updates and amendments, including activating and deactivating codes and maintenance of the hospital standard tariff

Responsible for maintaining Private Medical Insurers\xe2\x80\x99 fee schedules to ensure compliance with Commercial contracts. Responsible for maintaining Consultant and Anaesthetist fee schedules for employees and non- employed physicians and surgeons

Provides input and clarity on billing queries ensuring invoiced amounts correspond to relevant insurance and payor contracts

Acts as point of contact for Healthcode

Supports the Healthcode configuration, setup and training to include insurer requirements and agreed contracts on pre-authorisation, secure messaging, membership enquiry, membership screening and price screening and to analyse electronic data monthly usage statistics

Maintain the Consultant EDI file and the Healthcode Industry Standard Code Mapping file

Maintains the CCSD schedule and other PMI insurer amendments to their schedule of procedures

Distributes coding updates to relevant departments

Maintains ICD9 and ICD10 files

Understands revenue cycle functions and performance metrics and assist in development of tools and processes to review revenue cycle performance as required

Monitors and audits revenue cycle by department/institute, and provides support and tools to Department Managers in respect of daily charge capture and escalates remedial action accordingly

Oversees data transfer agreements when applicable

Develops Management Protocol and Billing Guidelines and ensures they are followed\xe2\x80\x8b Ensures internal control of Chargemaster

Assists in the creation, compilation and review of Revenue Cycle policy and procedures

Serves as a subject matter expert and provides consultative services in areas of Chargemaster and charge capture as requested

Other duties as assigned

What we need from you?

Substantial experience in a large clinic/group practice or hospital patient accounting operations

Offset: Equivalent professional experience may offset the degree requirement

Previous Chargemaster and UK PMI insurer contract understanding

Extensive experience and involvement in healthcare related electronic systems and patient financial reporting functions, patient account auditing and private hospital EMR systems

Demonstrable management and reimbursement/revenue cycle experience

What we can offer you?

We are offering an array of benefits to compliment working for a not-for-profit market leader, some of our benefits include:

25 days Annual leave plus 8 days Bank holiday a year

Auto-Enrolment of 5% pension - Cleveland contribute 10% through Salary Exchange

Private Medical Insurance and Private Dental Insurance

Life Assurance

Discounted gym facilities in our Admin Office Building

Employee Assistance Programme

Seasonal Ticket Loans

The closing date is 06/10/2023, however we may close the role early due to application numbers, click apply below.

Please see Important Information below:

Disclosure and Barring Service (DBS) Check

This post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order (as amended) and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (DBS) to check for any previous criminal convictions.



\xe2\x80\x9cLet\xe2\x80\x99s deliver World Class care together!\xe2\x80\x9d

As an equal opportunities employer, we aspire to work together to promote a more inclusive work environment, which represents our commitment to celebrate diversity.

CCL is committed to applying its Equal Employment Opportunity/Workforce Diversity and Inclusion Policy at all stages of recruitment and privileging. Shortlisting, interviewing and selection will always be carried out without regard to any Protected Characteristics. When aware of the need to do so and when required, CCL will make reasonable adjustments to its arrangements for interviews and to conditions of employment/engagement for disabled applicants to ensure, so far as practicable, that they do not place such applicants at a substantial disadvantage in comparison to non-disabled applicants.

Cleveland Clinic London