Coordinates the billing and follow up processbetween the organization, payers and patients with minimal guidance.Recognizes, researches, reconciles, and reports appropriate corrective actionplans on trends related to patient account inquiries and payer denials.
Processes claims, payments, adjustments, refunds, denials, and unpaid patient and insurance balances.
Accesses and corrects, if needed, demographic, insurance and financial information.
Provides accurate account maintenance and documentation.
Serves as a liaison with insurance companies, third party payors, and administrative personnel.
Analyzes incoming financial data to identify, reconcile, and resolve patterns resulting in erroneous or no reimbursement.
The responsibilities listed are a general overview of the position and additional duties may be assigned.
CODING KNOWLEDGE (NOVICE):- Ability to assign and interpret ICD-10-CM/PCScoding classification systems and MS-DRG and APR-DRG prospective payment andseverity systems.
DATA ENTRY (INTERMEDIATE):- The ability to transcribe information fromthe original source into an electronic system according to written and verbalinstructions efficiently and accurately.
REVENUE CYCLE (NOVICE):- Knowledge of the financial process to trackpatient care from registration and scheduling to the final payment of abalance.
Organizational Impact: Performs non-routine tasks that significantly impact team's performance with minimal guidance.
Problem Solving/ Complexity of work: Conducts research and analysis to solve some non-routine problems.
Breadth of Knowledge: Applies broad job knowledge and has basic job skills in other areas.
Team Interaction: Provides informal guidance and support to less experienced team members.
SUPPORTING COLLEAGUES (S3):
- Develops Self and Others: Continuously improves own skills by identifying development opportunities.
- Builds and Maintains Relationships : Seeks to understand colleagues' priorities, working styles and develops relationships across areas.
- Communicates Effectively: Openly shares information with others and communicates in a clear and courteous manner.
DELIVERING EXCELLENT SERVICES (S3):
- Serves Others with Compassion: Invests time to understand the problems, needs of others and how to provide excellent service.
- Solves Complex Problems: Seeks to understand issues, solves routine problems, and raises proper concerns to supervisors in a timely manner.
- Offers Meaningful Advice and Support: Listens carefully to understand the issues and provides accurate information and support.
ENSURING HIGH QUALITY (S3):
- Performs Excellent Work: Checks work quality before delivery and asks relevant questions to meet quality standards .
- Ensures Continuous Improvement: Shows eagerness to learn new knowledge, technologies, tools or systems and displays willingness to go above and beyond.
- Fulfills Safety and Regulatory Requirements: Demonstrates basic knowledge of conditions that affect safety and reports unsafe conditions to the appropriate person or department.
MANAGING RESOURCES EFFECTIVELY (S3):
- Demonstrates Accountability: Takes responsibility for completing assigned activities and thinks beyond standard approaches to provide high-quality work/service.
- Stewards Organizational Resources: Displays understanding of how personal actions will impact departmental resources.
- Makes Data Driven Decisions: Uses accurate information and good decision making to consistently achieve results on time and without error.
FOSTERING INNOVATION (S3):
- Generates New Ideas: Willingly proposes/accepts ideas or initiatives that will impact day-to-day operations by offering suggestions to enhance them.
- Applies Technology: Absorbs new technology quickly; understands when to utilize the appropriate tools and procedures to ensure proper course of action.
- Adapts to Change: Embraces change by keeping an open mind to changing plans and incorporates change instructions into own area of work.
High School Diploma or GED (or equivalentexperience) and 4 years relevant experience
Experiencewith Insurance Authorizations and Billing
Experiencewith Analytical Reporting
Experiencewith reviewing and resolving accounts with multiple insurance payors
Our programs in rehabilitation extend to our community forcontinuous learning and support of future professionals. With over 70 contractsto professional schools across the United States, we provide training for over50 occupational and physical therapy students and 60 audiologist andspeech-language pathologists annually. We host many continuing educationworkshops annually. A majority of these are open to a variety of medicalprofessionals as we strive to share our knowledge and remain current in thelatest therapy techniques, theories, and regulations that govern our practice.
Our Rehabilitation programs are actively involved incontinuous quality improvement through Focus Teams charged with the improvementof a service area through ensuring evidenced based practice, continuedcompetencies for staff, and consistency of practice and documentation. To learn more about any of ourservice areas, extensive programs for students, or employment and educationalopportunities, explore our Rehabilitation Services at VUMC REHAB
Locatedin Nashville, Tennessee, and operating at a global crossroads of teaching,discovery and patient care, VUMC is a community of individuals whocome to work each day with the simple aim of changing the world. It is a placewhere your expertise will be valued, your knowledge expanded and your abilitieschallenged. It is a place where your diversity â of culture, thinking, learningand leading â is sought and celebrated. It is a place where employees know theyare part of something that is bigger than themselves, take exceptional pride intheir work and never settle for what was good enough yesterday. Vanderbiltâs mission is to advancehealth and wellness through preeminent programs in patient care, education, andresearch.
Becausewe are committed to providing the best in patient care, education and research,we are proud of our recent accomplishments:
USNews & World Report: #1 Hospital in Tennessee, #1 HealthCare Provider in Nashville, #1 Audiology (Bill Wilkerson Center), 9 adult and 9pediatric clinical specialties ranked among the nation's best, #15 Educationand Training
TruvenHealth Analytics: among the top 100 hospitals in the US
Becker'sHospital Review: oneof the "100 Greatest Hospitals in America"
TheLeapfrog Group: grade"A" in Hospital Safety Score
NationalInstitutes of Health: among the top 10 grant awardees for medicalresearch in the US
AmericanAssociation for the Advancement of Science: 12 facultymembers elected fellows in 2014
MagnetRecognition Program: Vanderbilt nurses are the only group honored inMiddle Tennessee
Vanderbilt University Medical Center is a comprehensive health care facility dedicated to patient care, research, and biomedical education. Our reputation for excellence in these areas has made us a major center for patient referrals from throughout the Mid-South. Each year, people throughout Tennessee and the Southeast choose Vanderbilt University Medical Center for their health care because of our leadership in medical science and our dedication to treating patients with dignity and compassion.The mission of Vanderbilt University Medical Center is to advance health and wellness through preeminent programs in patient care, education, and research.