Senior Account Reimbursement Specialist (Hospital Billing)

Vanderbilt University Medical Center•Nashville, TN

About The Position

Vanderbilt University Medical Center (VUMC) is seeking a Senior Account Reimbursement Specialist for its Hospital Billing department. This role involves coordinating the billing and follow-up process between the organization, payers, and patients with minimal guidance. The specialist will be responsible for recognizing, researching, reconciling, and reporting on trends related to patient account inquiries and payer denials, and implementing corrective action plans. VUMC is committed to an environment where everyone can thrive and where uniqueness is celebrated, fostering a sense of purpose and pride in work. The mission is to advance health and wellness through patient care, education, and research.

Requirements

4 years of relevant work experience
High School Diploma or GED
Revenue Cycle (Novice): Knowledge of the financial process to track patient care from registration and scheduling to the final payment of a balance.
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.

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.
Performs non-routine tasks that significantly impact team's performance with minimal guidance.
Conducts research and analysis to solve some non-routine problems.
Provides informal guidance and support to less experienced team members.
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.
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 in a timely manner.
Offers Meaningful Advice and Support: Listens carefully to understand the issues and provides accurate information and support.
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.
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.
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 changes by keeping an open mind to changing plans and incorporates change instructions into own area of work.