AdventHealth

Account Representative II - Billing/Collections/Denials

AdventHealth

full-time

Posted on:

Origin:  • 🇺🇸 United States • Florida

Visit company website
✨ AI Apply
Manual Apply

Job Level

Mid-LevelSenior

Tech Stack

Go

About the role

  • The role you will contribute: Under general supervision and direction, it's the responsibility of the Account Representative II to bill, follow-up, and manage denials to timely collect on assigned accounts receivable.
  • Daily communicates with team members and manager on assigned projects in collaboration to meet prescribed deadlines.
  • Examines contracts, and learns payer contracts to understand reimbursement methodology to appropriately reconcile patient accounts.
  • Resolves and resubmits rejected claims appropriately as necessary.
  • Processes daily and special reports, unlisted invoices and letters, error logs, stalled reports, and aging claim reports.
  • Reviews previous account documentation, determining appropriate action(s) necessary to resolve avoid denial, and facilitate timely payment.
  • Performs outgoing calls and accepts incoming calls from patients and insurance companies to obtain necessary information for accurate billing, collections, and correction of denials, accurately documenting the patient account.
  • Actively prioritizes all outstanding customer service concerns and accepts responsibility in maintaining relationships that are equally respectful to all.
  • Participates in continuing education, team meetings, and performs other functions as assigned by supervisor/manager.
  • Adheres to AdventHealth Corporate Compliance Plan and to all rules and regulations of all applicable local, state, and federal agencies and accrediting bodies.
  • Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
  • The value you will bring to the team: Works with insurance payers to ensure proper billing, collections, or denial management on patient accounts.
  • Depending on payer contract may be required to participate in conference calls, review accounts receivable reports, and compile the issue report to expedite resolution of accounts.
  • Examines contract to ensure proper reimbursement, helps educate team members on inconsistencies in processing, and document any changes contract, if identified.
  • 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, billing) to appropriately work patient accounts.
  • Assists customer service with patient concerns/questions to ensure prompt and accurate resolution is achieved.
  • Produces written correspondence to payors and patients regarding status of claim, requesting additional information, etc.
  • Reviews previous account documentation, determining appropriate action(s) necessary to resolve each assigned account.
  • Initiates next billing, 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 companies Documents billing, denials and/or 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.
  • Consistently communications with team members to foster a collaborative atmosphere and engages with supervisor/manager on any potential educational opportunities, providing updates on assigned projects.
  • Attends required scheduled meetings, events, and activities
  • Assists team members regularly, providing feedback, ensuring both goals and job requirements are met as assigned by manager.
  • Helps with training new staff, performs audits of work performed, and communicates progress to appropriate supervisor.
  • Assist the supervisor/manager as requested.
  • Adheres to HIPAA regulations by verifying pertinent information to determine caller authorization level receiving information on account
  • Takes on department projects as assigned by their supervisor and/or manager

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.
  • Proficiency in Microsoft office products such as Word and Excel.
  • Associate Preferred
  • Certified Revenue Cycle Rep (CRCR) Preferred