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.
JOB CODE INFORMATION:
Job Code: 3469
JOB SUMMARY: Process insurance billing according to third party payor's guidelines. Adjust accounts to appropriately reflect account balances. Supervise, coordinate and review work of designated staff. Developing and training of staff on policies and procedures, evaluate employee performance, recommend employees for hire and disciplinary action.
Monitor and Coordinate Programs and Actions
Responsible for administering insurance collection policies and procedures to all staff
Conduct interviews to evaluate qualification of applicants/potential employees including temporary staff
Counsel employees with regard to disciplinary actions taken in response to violations of institutional policies or contractual provisions
Identify and Resolve Problems
Provide information to others (oral or written) to explain/clarify problems, issues or requests
Meet with other professional/technical personnel to determine causes of a specific problem
Supervise maintenance of the patient accounting and statistical recording system for insurance collections
Provide support to Assistant Director
Act as a back up for the Assistant Director to cover meetings with staff, payors and departments
Assist in developing policies and procedures as well as giving input on work flow processes
Organize and oversee assigned projects, both internal and with Business Associates
Provide supervision, support and educational training for internal staff and Business Associates staff for assigned projects
Establish and administer policies and procedures for assigned projects
Organize, schedule and monitor the daily operations of collecting account receivables and/or processing account payables
Communicate stated billing guidelines to staff
Ensure supervised staff follows established policies and procedures
Fairly administers policies to all supervised staff
Review and approve all correspondence, claims, adjustments and/or collection documents for distribution to Vanderbilt departments and external organizations
Maintain proper documentation
Keep accurate status reports and submit same in a timely manner
Review system generated reports to evaluate productivity level and resolve problems
Provide overall supervision of staff which may include:
Provide oral instructions and methods for new work processes.
Document staff performance functions.
Maintain accurate tardy/attendance records on each staff member including receipt of appropriate documentation from staff member
Assign and delegate work in a fair manner to all employees.
Monitor employees work to ensure completion of assigned tasks.
Motivate staff and give productive feedback or instructions
May review, monitor and prepare employee Matrix reports, following appropriate guidelines for completion of Matrix and submitting Matrix prior to deadline.
Ability to audit accounts and take or recommend appropriate action
Demonstrates ability to audit complex accounts accurately
Audit and identify overpayment and determine reason for credit
Make appropriate resolution
Seek help when necessary to resolve credit issues
Receive and respond to special requests and resolve complex insurance and/or patient account problems
Ability to apply managerial discretion when adjusting or approving adjustments to alter the financial balance of a patient account.
Able to approve refund requests effectively for staff for assigned amounts.
Make good decisions regarding adjustments to accounts
Able to recognize payor specific problems affecting account balances
Recognize payor errors resulting in lost revenue
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 ), 9 adult and 9 pediatric clinical specialties ranked among the nation's best, #15 Education and Training
Truven Health Analytics: among the top 100 hospitals in the US
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
American Association for the Advancement of Science: 12 faculty members elected fellows in 2014
Magnet Recognition Program: Vanderbilt nurses are the only group honored in Tennessee
Nashville Business Journal: Middle Tennessee's healthiest employer
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 disea...se.
As the 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.