Job Description
Vanderbilt Health
Nashville, Tennessee, Organization: Research Billing Compliance Job Summary: Discover Vanderbilt University Medical Center: Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of diverse 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. Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and 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 SUMMARY Reviews and ensures accuracy of charges for services and determines appropriate resolution, independently. Corrects errors to quickly process delayed claims. . KEY RESPONSIBILITIES
* Tracks, monitors, and updates billing systems.
Updates system functionality in response to changes in overall billing practices or other operational changes.
* Manages the workflow within the systems to maintain timely and thorough review of documentation.
* Performs analysis of charges generated from systems to verify accuracy.
* Identifies deficiencies or discrepancies in provider documentation that affects billing.
* Collaborates with department administrators in the development and implementation of strategic charging initiatives.
* The responsibilities listed are a general overview of the position and additional duties may be assigned. TECHNICAL CAPABILITIES
* System Knowledge (Intermediate): Knowledge of the operation and support of the system from the standpoint of computer operations, network operations, and/or technical support.
* Coding Knowledge (Advanced): 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.
* Problem Solving (Intermediate): 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.
* Presentation Skills (Intermediate): The ability to prepare effective presentations in content and function, able to speak competently to the level of the audience. Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and to the principles of equal opportunity and affirmative action. EOE/AA/Women/Minority/Vets/Disabled 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 delivers on objectives with understanding of how they impact the results of own area/team and other related teams.
Problem Solving/ Complexity of work: Utilizes multiple sources of data to analyze and resolve complex problems; may take a new perspective on existing solution. Breadth of Knowledge: Has advanced knowledge within a professional area and basic knowledge across related areas. Team Interaction: Acts as a “go-to” resource for colleagues with less experience; may lead small project teams. 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 understand current and future needs of relevant stakeholders and customizes services to better address them. – Solves Complex Problems: Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions. – Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees’ effectiveness. Ensuring High Quality: – Performs Excellent Work: Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly.
– Ensures Continuous Improvement: Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them. – Fulfills Safety and Regulatory Requirements: Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring. Managing Resources Effectively: – Demonstrates Accountability: Demonstrates a sense of ownership, focusing on and driving critical issues to closure. – Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area. – Makes Data Driven Decisions: Demonstrates strong understanding of the information or data to identify and elevate opportunities. Fostering Innovation: – Generates New Ideas: Proactively identifies new ideas/opportunities from multiple sources or methods to improve processes beyond conventional approaches. – Applies Technology: Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges. – Adapts to Change: Views difficult situations and/or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements. Position Qualifications: Responsibilities: Certifications: Work Experience: Relevant Work Experience Experience Level: 4 years Education: High School Diploma or GED For a copy of the physical requirements of this position to determine if you can perform the duties with or without an accommodation or to request an accommodation, please contact VUMC Employee Relations at 615-343-4759 or employeerelations. vumc@vumc.
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