Sr. Account Reimbursement Specialist, PRN

JOB SUMMARY:

In your pivotal role as Sr. Account Reimbursement Specialist PRN, you will coordinate the billing and follow-up process between the organization, payers and patients with minimal guidance. You also will recognize, research, reconcile, and report appropriate corrective action plans on trends related to patient account inquiries and payer denials. This is a PRN, as needed position. Billing experience required.

DEPARTMENT SUMMARY:

This team is responsible for the management of the revenue cycle for the Vanderbilt Medical Group. This consists of credentialing and enrolling providers, coding and charge capture of professional revenue, claims processing, collections, and customer service. The group has four primary divisions: Provider Support Services, VMG Business Office, Coding Services, and Physician Billing Services. For more information, please visit https://finance.vumc.org/vmg/

SHIFT/LOCATION:

Monday-Friday, standard AM 8-hour shift; 40 hours weekly; this position will work at Green Hills.

View how Vanderbilt Health employees celebrate the difference they make every day:

Discover Vanderbilt University Medical Center:

Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded and your abilities challenged. It is a place where your diversity -- of culture, thinking, learning and leading -- is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research.

VUMC Recent Accomplishments

Because we are committed to providing the best in patient care, education and research, we are proud of our recent accomplishments:

* US News & World Report: #1 Adult Hospital in Tennessee and metropolitan Nashville, named to the Best Hospitals Honor Roll of the top 20 adult hospitals, 10 nationally ranked adult specialty programs, with 3 specialties rated in the top 10 nationally, Monroe Carell Jr. Children's Hospital at Vanderbilt named as one of the Best Children's Hospital in the nation, with 10 out of 10 pediatric specialties nationally ranked.

* Healthcare's Most Wired: Among the nation's 100 "most-wired" hospitals and health systems for its efforts in innovative medical technology.

* Becker's Hospital Review: named as one of the "100 Great Hospitals in America", in the roster of 100 Hospitals and Health Systems with Great Oncology Programs and to its list of the 100 Hospitals with Great Heart Programs.

* The Leapfrog Group: One of only 10 children's hospitals in the to be named at Leapfrog Top Hospital.

* American Association for the Advancement of Science: The School of Medicine has 112 elected fellows

* Magnet Recognition Program: Received our third consecutive Magnet designations.

* National Academy of Medicine: 22 members, elected by their peers in recognition of outstanding achievement

* Human Rights Campaign Healthcare Equality Index: 6^th year in a row that Vanderbilt University Medical Center was a Leader in LGBTQ Healthcare Equality.

KEY RESPONSIBILITIES:

• 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.

TECHNICAL CAPABILITIES:
CODING KNOWLEDGE (NOVICE):- Ability to assign and interpret ICD-10-CM/PCS coding classification systems and MS-DRG and APR-DRG prospective payment and severity systems.

DATA ENTRY (INTERMEDIATE):- The ability to transcribe information from the original source into an electronic system according to written and verbal instructions efficiently and accurately.

REVENUE CYCLE (NOVICE):- Knowledge of the financial process to track patient care from registration and scheduling to the final payment of a balance.

CORE ACCOUNTABILITIES:

• 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.

CORE CAPABILITIES:

SUPPORTING COLLEAGUES:

• 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:

• 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:

• 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:

• 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:

• 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.

REQUIRED:

• High School Diploma or GED (or equivalent experience)
• 4 years relevant experience

Physical Requirements/Strengths needed & Physical Demands:

• • Sedentary category requiring exertion up to 10 lbs. of force occasionally and uses negligible amounts of force to move objects. Sedentary work involves sitting most of the time.
  
  Movement
  • Occasional: Standing: Remaining on one's feet without moving.
  • Occasional: Walking: Moving about on foot.
  • Occasional: Lifting under 35 lbs: Raising and lowering objects under 35 lbs from one level to another
  • Occasional: Carrying under 35 lbs: Transporting an object holding in hands, arms or shoulders, with help of coworkers or assistive device.
  • Occasional: Push/Pull: Exerting force to move objects away from or toward.
  • Occasional: Bending/Stooping: Trunk bending downward and forward by bending spine at waist requiring full use of lower extremities and back muscles
  • Occasional: Reaching above shoulders: Extending arms in any direction above shoulders.
  • Occasional: Reaching below shoulders: Extending arms in any direction below shoulders.
  • Occasional: Handling: Seizing, holding, grasping, turning or otherwise working with hand or hands.
  • Occasional: Bimanual Dexterity: Requiring the use of both hands.
  • Frequent: Sitting: Remaining in seated position
  • Frequent: Fingering: Picking, pinching, gripping, working primarily with fingers requiring fine manipulation.
  
  Sensory
  • Continuous: Communication: Expressing or exchanging written/verbal/electronic information.
  • Continuous: Auditory: Perceiving the variances of sounds, tones and pitches and able to focus on single source of auditory information
  • Continuous: Vision: Clarity of near vision at 20 inches or less and far vision at 20 feet or more with depth perception, peripheral vision, color vision.