Lead Account Reimbursement Specialist (Financial Counseling Dept)

Discover Vanderbilt Health : With eight hospitals and over 180 clinics, we are the region’s largest comprehensive academic health system. Vanderbilt Health has a long tradition of providing world-class care to the people of the Mid-South, living out our mission of moving medicine forward through preeminent programs in patient care, education and research. Here you’ll find a spirit of collaboration and a supportive community where your expertise is valued, your knowledge expanded and your uniqueness celebrated. We are committed to fostering an environment where talented, compassionate people are united in bringing the most advanced care to our neighbors throughout the region.
Organization:
OHO Financial Counseling 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. .
KEY 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.

- The responsibilities listed are a general overview of the position and additional duties may be assigned.

TECHNICAL CAPABILITIES

- 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.

Our professional administrative functions include critical supporting roles in information technology and informatics, finance, administration, legal and community affairs, human resources, communications and marketing, development, facilities, and many more.

At our growing health system, we support each other and encourage excellence among all who are part of our workforce. High-achieving employees stay at Vanderbilt Health for professional growth, appreciation of benefits, and a sense of community and purpose.

Core Accountabilities:
* 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 precendent.* 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. Core Capabilities :
Supporting Colleagues: - Develops Self and Others: Invests time, energy, and enthusiasm in developing self/others to help improve performance e and gain knowledge in new areas. - Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships. - Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences. Delivering Excellent Services : - Serves Others with Compassion: Seeks to