Billing, Collections and Denials Account Representative II
AdventHealth
full-time
Posted on:
Location Type: Remote
Location: Remote • Florida • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
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
Benefits
- Benefits from Day One
- Career Development
- Whole Person Wellbeing Resources
- Mental Health Resources and Support
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
billingcollectionsdenial managementcontract examinationclaims processingadministrative appealsmedical appealsbasic math functionstyping skills
Soft skills
discretionresponsivenessself-motivatorquick thinkerprofessional communicationanalytical skillsresearch skillscollaborationtraining