Department Workleader

Join 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 world.   

As a Department Workleader, you serve as a supportive, knowledgeable, and reliable resource for your team. You will perform essential tasks that promote quality patient care, unit cohesion, efficient workflow, and appropriate training. This support role bridges leadership and frontline caregivers, helping reduce escalations and ensure accurate payment outcomes. Your work is vital to delivering the best possible experience for patients, families, and visitors.

A caregiver in this role works remotely from 8:00 a.m. – 5:00 p.m.

To be considered for this role, caregivers must be local and able to attend onsite meetings at West Creek as needed.

A caregiver who excels in this role will:

• Serve as the work leader and perform various duties to support the department.

• Coordinate resources for daily assignments and manage work schedules.

• Distribute work to maintain departmental workflow and ensure adequate desk coverage.

• Supervise departmental functions and resources in the manager’s absence.

• Participate in project teams to build competency in department tools and methods that support organizational performance improvement.

• Conduct quality monitoring, provide training, recommend process improvements, and maintain documented processes and procedures.

• Review aged, problem, and escalated accounts.

• Interpret and apply insurance contract terms.

• Validate whether claims were paid correctly according to contract.

• Identify underpayments and overpayments.

• Determine whether payer reductions are contractually appropriate.

• Support global billing processes.

• Assist with follow-up and resolution activities.

• Perform reconciliation of payments and accounts.

• Partner directly with payers, network services, and market teams.

• Participate in escalated payer calls and discussions.

• Monitor and manage work queues (WQs) to ensure claims or accounts are routed correctly, prioritized appropriately, progressing through workflows, and reassigned based on volume, staffing, or urgency.

• Adjust priorities during staffing constraints or workflow challenges, ensuring team alignment with current operational priorities.

• Serve as the first escalation point for workflow breakdowns, system or routing issues, process gaps, and barriers preventing staff from working accounts.

• Answer daily questions, reinforce standard work, provide real-time guidance, and remove blockers to support staff productivity.

• Ensure teams follow SOPs and standard work, align workflows with enterprise expectations, and apply process changes consistently.

• Represent frontline challenges to management and provide operational context regarding volume, staffing, and workflow constraints.

• Support leadership discussions by delivering real-time operational insights.

• Serve as the primary operational contact for Cleveland Clinic business partners regarding account review requests, financial trend inquiries, and identification of payer performance gaps.

• Partner with the Manager and Analyst to monitor performance trends and proactively address spikes or declines in key metrics.

• Use monthly dashboards to create daily visualization boards that highlight priorities, progress, and areas requiring immediate attention.

• Translate data into actionable daily callouts (e.g., top drivers, aging risks, timeliness concerns) to guide team and caregiver focus.

Minimum qualifications for the ideal future caregiver include:  

• High School Diploma or GED and three years of experience coordinating multiple tasks  

• OR Associate’s Degree and two years of experience  

• OR Bachelor’s Degree and one year of experience 

Preferred qualifications for the ideal future caregiver include: 

• Leadership experience or experience providing work direction

• Understanding of insurance contracts and complex reimbursement methodologies, particularly within global billing environments

• Strong understanding of Contract interpretation (especially transplant contracts)

• Strong understanding of Payment reconciliation

• Ability to determine contract compliance vs. standard medical plan billing

• Experience across billing, follow-up, and reconciliation

• Strong presentation and communication skills

Physical Requirements:

• Ability to perform work in a stationary position for extended periods

• Ability to operate a computer and other office equipment

• Ability to travel throughout the hospital system

• Ability to communicate and exchange accurate information

• In some locations, ability to move up to 20 pounds

Personal Protective Equipment:

• Follows standard precautions using personal protective equipment as required.