The Financial Clearance Specialist position services two areas within the Vanderbilt Bill Wilkerson Center--Pi Beta Phi Rehabilitation Institute (PBPRI) and Acute Care Speech-Language Pathology section (Acute SLP). In both practice areas, the role of the Financial Clearance Specialist is to manage the insurance process for patients referred for services in each program. These responsibilities include contacting the insurance company for each patient and determining coverage for the variety of services provided, including identifying policy restrictions or exclusions related to the services provided in each practice area. The Financial Clearance Specialist communicates insurance information to the Associate Access Specialists and the Assistant Manager so that the scheduling process may proceed. When there are issues with insurance coverage, the Financial Clearance Specialist communicates with the patient and his or her family to discuss the policy limitations. The Financial Clearance Specialist also manages the re-authorization process, which requires submitting the appropriate documentation and frequent follow-up calls to the insurance company, to ensure that patient care is not interrupted. The Financial Clearance Specialist consults with the manager and assistant manager, as well as the patient, when billing issues arise.
High School Diploma or GED
2 years of relevant experience
Obtains certification from insurance companies for all office visits.
Verifies insurance information and registers cases in tracking system.
Evaluates patient assets and liabilities to determine ability to pay.
Reviews alternatives to admission and guides patient in applying for financial assistance.
Completes pre-certification, credit applications, and other necessary paperwork.
Performs investigative and follow-up work relating to reimbursement issues.
The responsibilities listed are a general overview of the position and additional duties may be assigned.
INSURANCE REGULATORY KNOWLEDGE: Demonstrates knowledge of the appropriate rules and regulations for insurance policies, claims, payment and coverage. Ability to interpret and explain rules and regulations that are ambiguous or unclear.
CUSTOMER SERVICE: A continuing focus on the needs and requirements of customers, anticipating their needs, remaining sensitive to customers while performing services for them, responsive to customer needs.
DATA ENTRY: The ability to transcribe information from the original source into an electronic system according to written and verbal instructions efficiently and accurately.
PROBLEM SOLVING: Uses critical thinking and process improvement i.e. coaches and mentors development of problem statement, describes current state, identifies root causes, creates future state, coaches and mentors development of solutions and action plans with a sustainability plan. Applies appropriate tools to address issues.
Organizational Impact: Performs tasks that are typically routine that may impact team's performance with occasional guidance.
Problem Solving/ Complexity of work: Utilizes some discretion and research to solve routine problems.
Breadth of Knowledge: Applies knowledge of standards, established processes and procedure that apply to your own job.
Team Interaction: Provides guidance to entry level co-workers.
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 tosupervisors 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.
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.
The Pi Beta Phi Rehabilitation Institute (PBRI) expands the traditional services of the Vanderbilt Bill Wilkerson Center by providing comprehensive neuro-rehabilitation services including:
The Institute serves as the neurological outpatient rehabilitation center for adolescents and adults at Vanderbilt Medical Center. Common neurological diagnoses treated include traumatic brain injury, stroke, Parkinson's disease, multiple sclerosis, brain tumors and balance disorders. An individualized, structured program is designed for each patient with a goal of maximizing independence in physical, cognitive and emotional functioning.
Our therapists work together as a team to ensure they are addressing issues with physical, cognitive, and emotional functioning, as well as communication, visual perception and daily living. Because the goals of each phase of the rehabilitation process differ, each outpatient therapy program may emphasize different therapies and different levels or aspects of functioning. For more information, please visit:
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 Hospital in Tennessee, #1 Health Care Provider in Nashville, #1 Audiology ( Bill Wilkerson Center ), 12 adult and 10 pediatric clinical specialties ranked among the nation's best, #15 Education and Training
* Truven Health Analytics: among the top 50 cardiovascular hospitals in the U.S.
* Becker's Hospital Review: one of the "100 Greatest Hospitals in America"
* The Leapfrog Group: grade "A" in Hospital Safety Score
* National Institutes of Health: among the top 10 grant awardees for medical research in the US
* Magnet Recognition Program: Vanderbilt nurses are the only group honored in Middle Tennessee
* Nashville Business Journal: Middle Tennessee's healthiest employer
* American Hospital Association: among the 100 "Most Wired" medical systems in the US
Internal Number: 2001473
About Vanderbilt Health
Vanderbilt University Medical Center is home to Vanderbilt University Hospital, The Monroe Carell Jr. Children’s Hospital at Vanderbilt, the Vanderbilt Psychiatric Hospital and the Vanderbilt Stallworth Rehabilitation Hospital. These hospitals experienced more than 61,000 inpatient admissions during fiscal year 2015. Vanderbilt’s adult and pediatric clinics treated nearly 2 million patients during this same period.Vanderbilt University Hospital and the Monroe Carell Jr. Children’s Hospital at Vanderbilt are recognized again this year by U.S. News & World Report’s Best Hospitals as among the nation’s best with 18 nationally ranked specialties. Vanderbilt University Medical Center is world renowned because of the innovation, work ethic and collegiality of its employees. From our health care advances to our compassionate care, Vanderbilt owes its accomplishments and reputation to staff and faculty who bring skill and drive and innovation to the medical center day after day. World-leading academic departments and comprehensive centers of excellence pursue scientific discoveries and transformational educational and clinical advances across the entire spectrum of health and disease.As th...e largest employer in middle Tennessee, we welcome those who are interested in ongoing development in a caring, culturally sensitive and professional atmosphere. Most of us spend so much of our lives at work, we want to be part of maintaining a workplace in which people support one another and encourage reaching for excellence. Many high-achieving employees stay at Vanderbilt because of the professional growth they experience and because of their appreciation of Vanderbilt’s benefits, public events and discussions, athletic opportunities, beautiful setting and, above all, sense of community and purpose.Vanderbilt and its employees share a set of mutual expectations that have been created with productivity, legality, fairness and safety always in mind. We believe that our investment in training and compensating employees multiplies in value when we enable individuals to deliver their best performance for the benefit of us all.