[Hiring] Research Billing Compliance Specialist @Vanderbilt University Medical Center

Role Description

Coordinates with departments to develop billing plans to help ensure financial compliance in research, under occasional guidance.

Qualifications

• Bachelor's degree
• 2+ years of relevant experience

Requirements

• Assists with developing and implementing compliance and financial audits of clinical research.
• Creates and maintains the reporting, education, and training for research billing compliance.
• Develops processes to transmit and coordinate billing information through regulatory and compliance teams.
• Assists in reviewing financial records, contracts, and other information necessary to ensure compliance with billing requirements.
• The responsibilities listed are a general overview of the position and additional duties may be assigned.

Technical Capabilities

• Regulatory Compliance (Intermediate): Demonstrates knowledge of the appropriate rules and regulations and applies them in difficult, stressful, and complex situations. Able to interpret and explain rules and regulations that are ambiguous or unclear. Directs others in interpreting rules and regulations on the job and trains others in them.
• Coding Knowledge (Fundamental Awareness): Ability to assign and interpret ICD-10-CM/PCS coding classification systems and MS-DRG and APR-DRG prospective payment and severity systems.
• Problem Solving (Intermediate): Uses critical thinking and process improvement; coaches and mentors development of problem statements, describes current state, identifies root causes, creates future state, and develops solutions and action plans with a sustainability plan.
• Clinical Knowledge (Intermediate): Knowledge of patient care including patient assessment and treatment, care planning, patient education, and evidence-based practice. Understanding of medical terminology and documentation.
• Revenue Cycle (Fundamental Awareness): Knowledge of the financial process to track patient care from registration and scheduling to the final payment of a balance.

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 solutions.
• 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 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

• Relevant Work Experience: 2 years
• Education: High School Diploma or GED

Benefits

This role offers the opportunity to make a meaningful impact within Vanderbilt Health, supported by a comprehensive benefits package which may include health, disability, retirement, and/or wellness offerings to enhance your well-being and professional growth.