Job ID: 958622
Facility: Vidant Health
Location: Greenville, NC
Date Posted: Jun 24, 2022
About Vidant Health
Vidant Health is a regional health system serving 29 counties in eastern North Carolina. We are working every day to improve the health of the 1.4 million people we serve. Vidant Health is made up of 8 hospitals, physician practices, home health, hospice, wellness centers and other health care services. Vidant Medical Center is affiliated with the Brody School of Medicine at East Carolina University. As a major resource for health services and education, Vidant Health strives to support local medical communities and to work with providers throughout the region to deliver quality care. Our goal is to enhance services that are available locally and to eliminate barriers involving time, distance and lack of awareness that sometimes prevent patients from receiving the care they need.
Coordinates and directs the daily activities of the Insurance Representatives responsible for follow-up on billed claims for ECU Health hospitals and SSOP.
Determines professional learning needs of staff and identifies short/long-term goals relevant to position.
Reviews and evaluates daily ATB's, workstations and ADHOC reports to ensure adequate and timely follow up is performed and the workload is equally distributed.
Reviews and approves contractual, administrative and legally unbillable adjustments in accordance with the policy.
Stays current on all of the contractual agreements with third party payers and the affects on claim filing/contract management as it applies to each ECU Health hospital and SSOP. Liaison for Managed Care reimbursement resolution.
Responsible for hiring, training, scheduling, performance evaluations and time and attendance.
Stays current on the federal, state & local government regulations and the affects on claim filing.
Performs other related responsibilities as required or requested.
Ensures that the policies and procedures pertaining to patient accounting are being followed in order to effectively reduce the accounts receivable in a timely manner to ensure overall profitability of the office.
Coaches and develops staff by continually monitoring the learning needs of each staff member and matching the skill set of each employee to the needs of the department. Supervisor will also be responsible for identifying short-term as well as long-term goals.
Reviews and approves contractual, administrative and legally unbillable adjustments based on third party payer regulations. All adjustments are made in accordance with established policies.
Analyzes Contract Management System underpayment reports and delegates accounts to the appropriate Representatives to follow up with the payers. Acts as liaison for resolution of contracted payer reimbursement issues. Managed Care assistance will be obtained if needed.
Screens, interviews and hires applicants. Assist new employees in their training and development. Responsible for the monitoring and performance evaluations of employees. Reviews scheduling and approves time and attendance.
Performs in accordance with accepted procedure and responds to special requests by management in a timely and accurate manner.
Adheres to the policies and procedures. Uses tact and courtesy in all interactions including but not limited to staff, patients and payers. Promotes a positive image and supports management in goals and objectives. Handles inquiries and complaints discreetly and effectively.
Evaluates and ensures that adequate and timely follow-up on accounts is being performed by each Insurance Representative for each ECU Health hospital and SSOP. Accounts greater than 120 days must be individually reviewed by the supervisor to ensure proper follow up and documentation has been done. Appropriate adjustments will be made to the workload when needed.
Reviews, analyzes, and communicates bulletins with the appropriate people to ensure there is no negative impact on reimbursement for all ECU Health hospitals and SSOP. Workshops and other meetings are attended to assist in keeping abreast of changes.
High School or higher required with 2 additional years formal education
4 years experience - Third party billing and reimbursement, insurance carriers, on the job training, accounting, or related can be substituted for additional education
Hybrid position - will be required to come on site once a week (office in Greenville, NC)
VMG Insurance Department
It is the goal of Vidant Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.
Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.
We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant’s qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.