Lead Account Reimbursement Specialist, Medicare (Insurance HB Denial & Follow Up) - REMOTE

Vanderbilt University Medical Center • Nashville, TN

14h • Remote

About The Position

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. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness 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. Organization: HB Denial and Follow-Up 10 Job Summary: Coordinates the billing and follow-up process between the organization, payers and patients independently. Analyzes and reports on insurance denial causes and trends. Acts as a resource and mentor for peers.

Requirements

• 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.
• Peer Leadership (Novice): The ability to show leadership and influence people of equal rank in an effort to accomplish team goals.
• Coding Knowledge (Intermediate): Ability to assign and interpret ICD-10-CM/PCS coding classification systems and MS-DRG and APR-DRG prospective payment and severity systems.
• Revenue Cycle (Intermediate): Knowledge of the financial process to track patient care from registration and scheduling to the final payment of a balance.
• Relevant Work Experience Experience Level: 5 years
• Education: High School Diploma or GED

Responsibilities

• Processes claims, payments, adjustments, refunds, denials, and unpaid patient and insurance balances.
• Accesses and corrects, if needed, demographic, insurance and financial information.
• 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.
• Performs account audits in their entirety as well as other complex projects.
• Prepares and maintains complex reports and records requiring the identification of sources, compilation, analysis and evaluation of data.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees