JOB SUMMARY: Coordinates the billing and followup 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.
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.
The responsibilities listed are a general overview of the position and additional duties may be assigned.
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.
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 (INTERMEDIATE):- Knowledge of the financial process to track patient care from registration and scheduling to the final payment of a balance.
PEER LEADERSHIP (NOVICE):- The ability to show leadership and influence people of equal rank in an effort to accomplish team goals.
Organizational Impact: Independently performs non-routine tasks that significantly impact team and other related teams.
Problem Solving/ Complexity of work: Gathers and analyzes data to solve problems that arise with little or no precedent.
Breadth of Knowledge: Applies advanced job knowledge and has developed a breadth of skills in other areas.
Team Interaction: Serves as a lead for the team by providing expertise and guidance to team members.
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.