Billing Collection Denials Account Rep I

AdventHealth; Town of Florida (NY); On-site; USD 25,000 - 39,000; Full time

Job summary

AdventHealth in Maitland, FL is seeking a Full-time Billing Specialist to verify patient insurance coverage, submit and follow up on claims, and resolve discrepancies. You will collaborate with multiple departments to ensure accurate coding and timely payments, while maintaining compliance with regulations and patient communication.

Required are a high school diploma and 1+ year experience in revenue cycle or related areas, with proficient knowledge of CPT/ICD-10/HCPCS and Microsoft Excel.

Qualifications

• Able to work with advanced billing procedures
• Knowledge of the Revenue Cycle and the links between departments: Charge Capture, Consumer Access, HIM, Coding, and Patient Financial Services
• Working knowledge of 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
• Self-motivated, quick thinker, communicates professionally and effectively in English
• Ability to work with all departments and all levels of management
• Basic understanding of an explanation of benefits (EOB)
• Basic knowledge of CPT, ICD-10, and HCPCS coding standards
• Strong organizational skills
• Strong keyboard and 10 key skills
• Proficiency in Microsoft Suite applications, specifically Excel and Word, as well as Outlook
• Ability to communicate effectively in written and oral form with diverse populations
• Interpersonal skills to promote teamwork
• Ability to multitask and function in a fast-paced environment
• Ability to prioritize and problem-solve
• Comfort with interpreting payer contractual language
• Ability to navigate payer portals for remittance research

Responsibilities

• Verifies patient insurance coverage and ensures accurate billing codes
• Submits claims to insurance payers and follows up on denials
• Resolves billing discrepancies and updates patient accounts
• Maintains compliance with billing regulations and explains benefits to patients

Skills

Revenue Cycle

Billing procedures

CPT/ICD-10/HCPCS

Excel

Outlook

Communication

Multitasking

Teamwork

Education

High School Diploma

Tools

Microsoft Suite

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

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 to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the 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.