AdventHealth

Account Representative II, Billing/Collection/Denials

AdventHealth

full-time

Posted on:

Origin:  • 🇺🇸 United States • Florida

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Job Level

Mid-LevelSenior

Tech Stack

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About the role

  • Responsible for billing, follow-up, and managing denials to timely collect on assigned accounts receivable.
  • This position communicates daily with team members and managers to meet prescribed deadlines.
  • This role examines contracts and learns payer contracts to understand reimbursement methodology and appropriately reconcile patient accounts.
  • This position resolves and resubmits rejected claims, processes daily and special reports, and reviews previous account documentation to determine necessary actions.
  • Additionally, this role performs outgoing and incoming calls with patients and insurance companies to obtain information for accurate billing and collections.
  • Works with insurance payers to ensure proper billing, collections, or denial management on patient accounts.
  • Examines contracts to ensure proper reimbursement, educates team members on inconsistencies, and documents any changes.
  • Works follow-up reports daily, maintaining established goals, and notifies the supervisor of issues preventing goal achievement.
  • Follows up on daily correspondence related to denials, underpayments, and billing to appropriately manage patient accounts.
  • Assists customer service with patient concerns and questions to ensure prompt and accurate resolution.
  • Produces written correspondence to payors and patients regarding claim status and requests for additional information.
  • Reviews previous account documentation to determine necessary actions to resolve assigned accounts.
  • Initiates next billing, follow-up, and collection steps, including contacting patients, insurers, or employers as appropriate.
  • Documents billing, denials, and collection steps taken, escalating to the supervisor or manager if necessary.
  • Processes administrative and medical appeals, refunds, reinstatements, and rejections of insurance claims.
  • Communicates consistently with team members to foster a collaborative atmosphere and engages with the supervisor or manager on educational opportunities.
  • Assists with training new staff, performs audits of work, and communicates progress to the appropriate supervisor.
  • Other duties as assigned.

Requirements

  • High School Grad or Equiv Required
  • 3+ Work Experience Required
  • Ability to use discretion when discussing personnel/patient related issues that are confidential in nature.
  • Ability to be responsive to ever-changing matrix of hospital needs and act accordingly.
  • Working knowledge of the Revenue Cycle and the links between departments: Charge Capture, Consumer Access, PreAccess, HIM, Coding, and Patient Financial Services.
  • Self-motivator, quick thinker, communicates professionally and effectively in English, both verbally and in writing.
  • Typing skills equal to 20 words per minute.
  • Proficiency in performance of basic math functions.
  • Ability to communicate professionally and effectively in English, both verbally and in writing.
  • Proficiency in Microsoft office products such as Word and Excel.
  • Strong analytical and research skills.
  • Able to conduct assigned work in either a fully remote or hybrid work environment
  • Cerner Patient Accounting SSI Claims Scrubber Epic
  • Preferred Qualifications: Associate Preferred
  • Certified Revenue Cycle Rep (CRCR) Preferred