Account Manager

• 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

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