SHSMD Career Center

Account Representative I Billing Collections and Denials

• Conveniently located near i-4 and Apopka expressway 414Career growth and advancement potential
• Benefits from Day One
• Paid Days Off from Day One
• Student Loan Repayment Program
• Career Development
• Pet Insurance

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

You Will Be Responsible For:   

• Works with Insurance payers to ensure proper billing takes place on all assigned patient accounts. Depending on payer contract may be required to participate in conference calls, accounts receivable reports, compiles the issue report in order to expedite resolution of accounts.
• Works follow up report daily, maintaining established goal(s), and notifies Supervisor, of issues preventing achievement of such goal(s). Follows up on daily correspondence (denials, underpayments) to appropriately work Patient accounts.
• Assists Customer Service with Patient concerns/questions to ensure prompt and accurate resolution is achieved. Produces written correspondence to payers and patients regarding status of claim, requesting additional information, etc.
• Initiates next billing, assign appropriate follow-up and/or collection step(s), this is not limited to calling patients, insurers or employers, as appropriate. Sends initial or secondary bills to Insurance payers.
• Documents billing, follow-up and/or assign collection step(s) that are taken and all measures to resolve assigned accounts, including escalation to Supervisor/Manager if necessary.
• Processes administrative and Medical appeals, refunds, reinstatements and rejections of insurance claims with the oversight of the Supervisor and/or Manager

EDUCATION AND EXPERIENCE REQUIRED:

·          One-year of experience in Revenue Cycle Department or related areas such as registration, finance, collections, customer service, medical, or contract management

KNOWLEDGE AND SKILLS REQUIRED:

·          Able to work with advanced billing procedures.

·          Able to prioritize and multitask based on volume of work within specific deadlines

·          Knowledge of the Revenue Cycle and the links between departments: Charge Capture, Patient Access, HIM, Coding, and Patient Financial Services.

·          Working knowledge involving coverage, payment, compliance, and basic billing rules for Government and Managed Care payers.

·          Uses discretion when discussing personnel/patient related issues that are confidential in nature.

·          Ability to give and follow written and verbal directions.

·          Working knowledge of personal computer applications and proficient in word, excel and power point applications. Self-motivator, quick thinker, communicates professionally and effectively in English, both verbally and in writing.

·          Ability to work with all departments and all levels of management.

Protects the financial standing of AdventHealth Central Florida Division South by performing functions related to the billing, coding, collection, payment, and customer service for all payer and patient accounts. Under general supervision, is responsible for processing insurance and billing insurance in a timely manner. Reviews assigned electronic claims and submission reports. Resolves and resubmits rejected claims appropriately as necessary. Works closely with HIM, Coding, Revenue Integrity, Patient Access, and Patient Financial Services departments to resolve outstanding claim errors by obtaining necessary information for accurate billing. Processes daily error logs, stalled reports, aging claims, and any ah-hoc reports. Addresses claim issues from insurance companies requesting additional information and/or checking status of billings.