Mister. PRN Account Refund Specification - 2211295
**Work**: Medical coding and billing
**Key location**: Work from home
**Organization**: Hospital Billing 108563
**Round:** : First round
**Description**
** Senior Account Refund Specialist, PRN**
**SUMMARY OF THE WORK:**
In his critical role as Senior Account Reimbursement Specialist, PRN, he will coordinate the billing and tracking process between the organization, payers and patients with minimal direction. You will also identify, investigate, reconcile and report appropriate corrective action plans on trends related to patient account inquiries and refusal to pay. This is an on-demand PRN. Billing experience required.
**DEPARTMENT SUMMARY:**
This team is responsible for managing the revenue cycle of Vanderbilt Medical Group. This includes provider accreditation and registration, coding and recording of professional income claims, claims processing, billing and customer service. The group has four main divisions: Provider Support Services, VMG Business Office, Coding Services and Physician Billing Services. For more information see [link removed] -Click here to apply for the Senior Account Refund Specification PRN/>
**SHIFT/LOCATION:**
Monday through Friday, standard 8-hour morning shift; 40 hours per week; this position will be based in Green Hills.
Watch Vanderbilt Health employees celebrate the difference they make every day:
**Discover Vanderbilt University Medical Center:**
Based in Nashville, Tennessee and operating at a global hub of teaching, research and patient care, VUMC is a community of people who come to work every day with the simple goal of changing the world. It's a place where your experience is valued, your knowledge enhanced and your skills challenged. It is a place where diversity in culture, thought, learning and leadership is sought and celebrated. It's a place where employees know they are part of something 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 wellbeing through excellence in patient care, education and research programs.
**Current VUMC Achievements**
As we are committed to providing the very best in patient care, education and research, we are proud of our recent achievements:
* **US News & World Report:** No. 1 adult hospital in Tennessee and Greater Nashville, named top 20 adult hospital honor list, 10 nationally ranked adult specialty programs, with 3 specialties in top 10 nation , the Monroe Carell Jr. Children's Hospital at Vanderbilt has been recognized as one of the top children's hospitals in the country, with 10 of the top 10 nationally ranked pediatric specialties.
* **Most Connected in Healthcare:** Named among the country's 100 Most Connected hospitals and healthcare systems for their efforts in innovative medical technology.
* **Becker's Hospital Review:** Named one of "America's 100 Great Hospitals" in its list of 100 Hospitals and Health Care Systems With Great Oncology Programs and in its list of 100 Hospitals With Great Heart Programs.
* **The Leapfrog Group:** One of 10 children's hospitals named Leapfrog Top Hospital.
* **American Association for the Advancement of Science:** The Medical School has 112 elected members
* **Magnet Recognition Program:** We received our third consecutive Magnet award.
* **National Academy of Medicine:** 22 members elected by their peers in recognition of excellence
* **Human Rights Campaign Health Care Equality Index: 6** **o** **Vanderbilt University Medical Center was a leader in LGBTQ health equality for a consecutive year.**
**MAIN RESPONSIBILITIES:**
+ Process patient and insurance claims, payments, adjustments, refunds, denials and unpaid balances.
+ Access and, if necessary, correct demographic, insurance and financial information.
+ Provides accurate accounting and documentation.
+ Acts as a liaison to insurers, third party payers and administrative staff.
+ Analyze incoming financial data to identify, match and resolve patterns that lead to erroneous refunds or no refunds.
+ The responsibilities listed are a general job description and additional roles may be assigned.
**TECHNICAL SKILLS:**
_CODING KNOWLEDGE (BEGINNER):_ - Ability to assign and interpret the CIE-10-CM/PCS code classification systems and the prospective payment and severity systems MS-DRG and APR-DRG.
_DATA ENTRY (ADVANCED):_ - The ability to efficiently and accurately transfer information from the original source into an electronic system in accordance with written and oral instructions.
_INCOME CYCLE (BEGINNER):_ - Knowledge of the financial process to oversee patient care from registration and planning to final balance payment.
**MAIN RESPONSIBILITIES:**
+ Organizational Impact: With minimal guidance, performs non-routine tasks that significantly impact team performance.
+ Troubleshooting / Complexity of work: Conduct investigation and analysis to solve some non-routine problems.
+ Breadth of Knowledge: Applies broad working knowledge and has basic professional skills in other fields.
+ Team Interaction - Provides informal guidance and support for less experienced team members.
**BASIC RESOURCES:**
SUPPORT COLLEAGUES:
+ Develop yourself and others: continuously improve your own skills, identify development opportunities.
+ Builds and maintains relationships: Attempts to understand colleagues' priorities and work styles and develops cross-departmental relationships.
+ Communicates effectively: Shares information openly with others and communicates clearly and politely.
EXCELLENT SERVICES:
+ Serve others with compassion: Take the time to understand the problems and needs of others and how to provide excellent service.
+ Solves Complex Problems: Strives to understand problems, solves routine problems and raises concerns with supervisors in a timely manner.
+ Provides meaningful advice and support: Listens carefully to understand problems and provides accurate information and support.
HIGH QUALITY GUARANTEE:
+ Does excellent work: checks the quality of the work before delivery and asks relevant questions to meet quality standards.
+ Ensures continuous improvement: shows enthusiasm in learning new knowledge, technology, tools or systems and shows a willingness to go further.
+ Meets Safety and Regulatory Requirements: Demonstrates basic knowledge of conditions affecting safety and reports unsafe conditions to the appropriate person or department.
MANAGE RESOURCES EFFECTIVELY:
+ Demonstrates accountability – takes responsibility for completing assigned activities and thinks beyond standard approaches to deliver quality work/service.
+ Organizational Resource Manager: Demonstrates understanding of how personal actions affect departmental resources.
+ Make data-driven decisions: Use accurate information and good decision-making to get results on time and without errors.
INNOVATION PROMOTION:
+ Generate new ideas: Propose/voluntarily accept ideas or initiatives that impact day-to-day operations and make suggestions for improvement.
+ Apply technology: absorb new technologies quickly; understands when to use the right tools and procedures to ensure the right course of action.
+ Adapts to Change: Embraces change by staying open to plans and incorporating change instructions into his own workspace.
**Qualifications - External**
**MANDATORY:**
+ High School Diploma or GED (or equivalent experience)
+ 4 years of relevant experience
**Physical requirements/Necessary strengths and physical requirements:**
+ Seated category requiring an effort of up to 10lbs. force from time to time and uses negligible amounts of force to move objects. In a sedentary job, you sit most of the time. **Movement**
+ Occasional: Standing: Standing without moving.
+ Occasionally: Walking: Getting around on foot.
+ Occasional: Lifting under 35 pounds: Raising and lowering objects under 35 pounds from one level to another
+ Occasional: Carrying less than 35 pounds: Carrying an object held in the hands, arms, or shoulders with the help of co-workers or an assistive device.
+ Occasional: Push/Pull: Apply force to move objects closer or further away.
+ Occasional: Squats/Bends: The torso curves down and forward as you bend your spine at the waist, requiring full engagement of your lower limbs and back muscles.
+ Casual: Shoulder Reach: Extend your arms over your shoulders in any direction.
+ Occasionally: Reach under shoulders: Extend arms under shoulders in each direction.
+ Uncommon: Manipulation: Grabbing, holding, grabbing, twisting, or otherwise working with the hand or hands.
+ Uncommon: Ambidextrous: Requires the use of both hands.
+ Common: Sitting: Remains in a sitting position
+ Common: Fingering: touching, pinching, grasping, working mostly with fingers that require delicate manipulation. **sensory**
+ Ongoing: Communication: expression or exchange of written/oral/electronic information.
+ Continuous: Auditory: Perceiving variations in sounds, pitches and pitches and being able to focus on a single source of auditory information
+ Continuous: Vision: Near vision to 20 inches or less and distance vision to 20 feet or more with depth perception, peripheral vision, color vision.
**Qualifications - Internal**
High school diploma or GED (or equivalent experience) and 4 years of relevant experience
**Licence, Certification and/or Registration (LCR):**
+ **Additional qualifying information:**
+ Accreditation and privileged experience required in a hospital environment. Instead of the diploma, a CPCS or CPMSM certification can be accepted. **Physical requirements/Necessary strengths and physical requirements:**
+ Seated category requiring an effort of up to 10lbs. force from time to time and uses negligible amounts of force to move objects. In a sedentary job, you sit most of the time. **Movement**
+ Occasional: Standing: Standing without moving.
+ Occasionally: Walking: Getting around on foot.
+ Occasional: Lifting under 35 pounds: Raising and lowering objects under 35 pounds from one level to another
+ Occasional: Carrying less than 35 pounds: Carrying an object held in the hands, arms, or shoulders with the help of co-workers or an assistive device.
+ Occasional: Push/Pull: Apply force to move objects closer or further away.
+ Casual: Shoulder Reach: Extend your arms over your shoulders in any direction.
+ Common: Sitting: Remains in a sitting position
+ Frequently: Reach under the shoulders: stretch your arms in any direction under your shoulders.
+ Common: Fingering: touching, pinching, grasping, working mostly with fingers that require delicate manipulation.
+ Common: Ambidextrous: Requires the use of both hands. **sensory**
+ Ongoing: Communication: expression or exchange of written/oral/electronic information.
+ Continuous: Auditory: Perceiving variations in sounds, pitches and pitches and being able to focus on a single source of auditory information
+ Continuous: Vision: Near vision to 20 inches or less and distance vision to 20 feet or more with depth perception, peripheral vision, color vision.
+ Continuous: Smell: Ability to detect and identify odors. **Environmental conditions**
+ Occasionally: Chemicals and gases: medicines, cleaning chemicals, oxygen, other medical gases used in the work area.
**License required 1**
No license or certification is required.
**Basic Qualification**
High school diploma or GED (or equivalent experience) and 4 years of relevant experience
+ **Additional qualifying information:**
+ Accreditation and privileged experience required in a hospital environment. Instead of the diploma, a CPCS or CPMSM certification can be accepted. **Physical requirements/Necessary strengths and physical requirements:**
+ Seated category requiring an effort of up to 10lbs. force from time to time and uses negligible amounts of force to move objects. In a sedentary job, you sit most of the time. **Movement**
+ Occasional: Standing: Standing without moving.
+ Occasionally: Walking: Getting around on foot.
+ Occasional: Lifting under 35 pounds: Raising and lowering objects under 35 pounds from one level to another
+ Occasional: Carrying less than 35 pounds: Carrying an object held in the hands, arms, or shoulders with the help of co-workers or an assistive device.
+ Occasional: Push/Pull: Apply force to move objects closer or further away.
+ Casual: Shoulder Reach: Extend your arms over your shoulders in any direction.
+ Common: Sitting: Remains in a sitting position
+ Frequently: Reach under the shoulders: stretch your arms in any direction under your shoulders.
+ Common: Fingering: touching, pinching, grasping, working mostly with fingers that require delicate manipulation.
+ Common: Ambidextrous: Requires the use of both hands. **sensory**
+ Ongoing: Communication: expression or exchange of written/oral/electronic information.
+ Continuous: Auditory: Perceiving variations in sounds, pitches and pitches and being able to focus on a single source of auditory information
+ Continuous: Vision: Near vision to 20 inches or less and distance vision to 20 feet or more with depth perception, peripheral vision, color vision.
+ Continuous: Smell: Ability to detect and identify odors. **Environmental conditions**
+ Occasionally: Chemicals and gases: medicines, cleaning chemicals, oxygen, other medical gases used in the work area.
**Mandatory ID:** 2211295
Vanderbilt University Medical Center is committed to the principles of equal opportunity and affirmative action.
recommended skills
- Administration
- charging
- business process improvement
- Complaints handling
- Corrective and preventive measures (shift)
- accreditation