Billing Collection Denials Account Rep I

AdventHealth; Florida; On-site; USD 25,000 - 39,000; Full time

Benefits offered by this job

Benefits from Day One: Medical

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Paid Time Off from Day One

403-B Retirement Plan

Parental Leave

Career Development

Whole Person Well-being

Mental Health Resources

Pet Benefits

Job summary

AdventHealth is seeking a Billing Specialist to verify patient insurance coverage, ensure accurate billing codes, and submit claims to payers. You will follow up on denials and resolve discrepancies while communicating with insurers and patients about coverage and responsibilities.

The role requires knowledge of the Revenue Cycle, CPT/ICD-10; strong organizational and multitasking abilities; and proficiency with Microsoft Office tools.

Qualifications

• Knowledge of Revenue Cycle and the links between departments: Charge Capture, Consumer 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.

Responsibilities

• Verifies patient insurance coverage and ensures accurate billing codes.
• Submits claims to insurance payers and follows up on denied claims.
• Updates patient accounts and communicates with insurance companies to clarify coverage details.

Skills

Revenue cycle

Billing procedures

Government payers

Managed care

Excel

Word

Outlook

Communication skills

Interdepartmental collaboration

Multitasking

Education

High School Grad or Equiv

Tools

Microsoft Excel

Microsoft Word

Outlook

Job description

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.

All the benefits and perks you need for you and your family:

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
• Paid Time Off from Day One
• 403-B Retirement Plan
• 4 Weeks 100% Paid Parental Leave
• Career Development
• Whole Person Well-being Resources
• Mental Health Resources and Support
• Pet Benefits

Schedule

Full time

Shift

Day (United States of America)

Address

900 WINDERLEY PL

City

MAITLAND

State

Florida

Postal Code

32751

Job Description

Verifies patient insurance coverage. Ensures accurate billing codes. Submits claims to insurance payers. Follows up on denied claims. Resolves billing discrepancies. Communicates with insurance companies to clarify coverage details. Updates patient accounts. Maintains compliance with billing regulations. Assists patients with understanding their insurance benefits and payment responsibilities. Understands managed care payment methodologies and principles. Interprets payment methodologies for various payer types. Receives and documents correspondence from auditing bodies. Other duties as assigned.

Knowledge, Skills, And Abilities

• Able to work with advanced billing procedures [Required]
• Knowledge of the Revenue Cycle and the links between departments: Charge Capture, Consumer Access, HIM, Coding, and Patient Financial Services [Required]
• Working knowledge involving coverage, payment, compliance, and basic billing rules for Government and Managed Care payers [Required]
• Uses discretion when discussing personnel/patient related issues that are confidential in nature [Required]
• Ability to give and follow written and verbal directions [Required]
• Self-motivator, quick thinker, communicates professionally and effectively in English, both verbally and in writing [Required]
• Ability to work with all departments and all levels of management [Required]
• Basic understanding of an explanation of benefits (EOB) [Required]
• Basic knowledge of CPT, ICD-10, and HCPCS coding standards [Required]
• Strong organizational skills [Required]
• Strong keyboard and 10 key skills [Required]
• Proficiency in Microsoft Suite applications, specifically Excel and Word applications, as well as Outlook [Required]
• Ability to communicate effectively in written and oral form with diverse populations [Required]
• Interpersonal skills to promote teamwork [Required]
• Ability to multitask and function in a fast-paced environment [Required]
• Ability to prioritize and problem-solve [Required]
• Comfort with interpreting payer contractual language [Preferred]
• Ability to navigate payer website/portals to perform remittance research and gather additional information needs [Preferred]

Education

• High School Grad or Equiv [Required]

Work Experience

• 1+ years of experience in revenue cycle department or related areas such as registration, finance, collections, customer service, medical, or contract management [Required]
• Experience in healthcare claims processing and proficiency with medical billing and remittance forms and processes, including 835 and 837 files, and UB04 and CMS-1500 (HCFA) forms [Preferred]

Physical Requirements

(Please click the link below to view work requirements)

Physical Requirements - https://tinyurl.com/23km2677

Pay Range

$17.80 - $28.48

Background Screening Requirement (Florida Law)

Certain positions are subject Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida's background screening requirements at Florida Care Provider Background Screening Clearinghouse:

https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.