Lead Account Reimbursement Specialist (Self-pay Follow Up / Quality Assurance)

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 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 is committed to an environment where everyone has the chance to thrive and where your uniqueness 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. Organization: Pt Liability & Customer Svc 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 verb