Shire Jobs

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.

Organization:

NLI Scheduling & Preauth

Job Summary:

JOB SUMMARY

The Financial Counselor performs the insurance quality control function for outpatient radiology, ensuring all pertinent information is available and accurately documented, allowing for timely and efficient billing. These activities include monitoring accounts for proper documentation, authorizations, insurance verifications, collection of deposits and self-pay balances, securing reimbursement methods of non-insured patients, computer update of accounts and the collection of verification of relevant patient data.

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KEY RESPONSIBILITIES

• Establishing health insurance benefits, conditions, and requirements by making phone inquiries, and by using eligibility systems and the internet.

• Furnishing patients and health care providers with estimates (electronic, mail or phone.)

• Collecting estimated liabilities from patients.

• Verifying patients’ employment details and other particulars for worker’s comp accounts.

• Manage work que accounts for coverage and registration errors, ensuring all pertinent information is available and accurately documented, allowing for timely and efficient billing.

• Assisting patients with financial applications and transfer information to the billing office for processing.

• Monitoring accounts for proper documentation of third-party review notification (research & transplant.)

TECHNICAL CAPABILITIES

• Insurance Regulatory Knowledge (Intermediate): Demonstrates knowledge of the appropriate rules and

regulations for insurance policies, claims, payment and coverage. Ability to interpret and explain rules and

regulations that are ambiguous or unclear.

• Communication of Results (Intermediate): Communicates results and recommendations to customers in

a concise and non-technical format. Clearly states implications and potential next steps. Presents

analysis, ideas, and findings using the appropriate data visualization and presentation tools [such as

Word, Excel, Tableau, and PowerPoint].

• 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.

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: Performs tasks that are typically routine that may impact team's performance with occasional guidance. * Problem Solving/ Complexity of work: Utilizes some discretion and research to solve routine problems. * Breadth of Knowledge: Applies knowledge of standards, established processes and procedure that apply to your own job. * Team Interaction: Provides guidance to entry level co-workers.

Core Capabilities :

Supporting Colleagues : Develops Self and Others: Continuously improves own skills by identifying development opportunities.- Builds and Maintains Relationships: Seeks to understand colleagues' priorities, working styles and develops relationships across areas.- Communicates Effectively: Openly shares information with others and communicates in a clear and courteous manner. Delivering Excellent Services: - Serves Others with Compassion: Invests time to understand the problems, needs of others and how to provide excellent service.- Solves Complex Problems: Seeks to understand issues, solves routine problems, and raises proper concerns in a timely manner. - Offers Meaningful Advice and Support: Listens carefully to understand the issues and provides accurate information and support. Ensuring High Quality: - Performs Excellent Work: Checks work quality before delivery and asks relevant questions to meet quality standards. - Fulfills Safety and Regulatory Requirements: Demonstrates basic knowledge of conditions that affect safety and reports unsafe conditions to the appropriate person or department. Managing Resources Effectively : - Demonstrates Accountability: Takes responsibility for completing assigned activities and thinks beyond standard approaches to provide high-quality work/service. - Stewards Organizational Resources: Displays understanding of how personal actions will impact departmental resources. - Makes Data Driven Decisions: Uses accurate information and good decision making to consistently achieve results on time and without error. Fostering Innovation : - Generates New Ideas: Willingly proposes/accepts ideas or initiatives that will impact day-to-day operations by offering suggestions to enhance them. - Applies Technology: Absorbs new technology quickly; understands when to utilize the appropriate tools and procedures to ensure proper course of action. - Adapts to Change: Embraces changes by keeping an open mind to changing plans and incorporates change instructions into own area of work.

Position Qualifications:

Responsibilities:

Certifications:

Work Experience:

Relevant Work Experience

Experience Level:

2 years

Education:

High School Diploma or GED (Required)

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