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Account Representative II – Medicaid
Location Address:900 Winderley Place, Maitland FL
Top Reasons to work at AdventHealth
Career growth and advancement potential
Full time hours with Benefits
Conveniently located near i-4 and Apopka expressway 414
We have Positive values with a productive and energetic atmosphere
Full Time/ Days
You Will Be Responsible For:
Works with Insurance payers to ensure proper billing takes place on all assigned patient accounts. Depending on payer contract may be required to participate in conference calls, accounts receivable reports, compiles the issue report in order to expedite resolution of accounts.
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) to appropriately work Patient accounts.
Assists Customer Service with Patient concerns/questions to ensure prompt and accurate resolution is achieved. Produces written correspondence to payers and patients regarding status of claim, requesting additional information, etc.
Initiates next billing, assign appropriate 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 payers.
Documents billing, follow-up and/or assign 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 with the oversight of the Supervisor and/or Manager.
EDUCATION AND EXPERIENCE REQUIRED:
Â· Two years of experience in a Revenue Cycle department or related areas such as registration, finance, collections, customer service, medical, or contract management
KNOWLEDGE AND SKILLS 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.
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.
Under general supervision, is responsible for billing insurance and insurance collections and denial management in a timely manner. Remains in consistent daily communication with Team members, including new process education, disciplinary actions, Reimbursement Lead and Reimbursement Manager regarding all aspects of assigned projects. Reviews assigned electronic claims and submission reports. Examines contracts for proper reimbursement. Resolves and resubmits rejected claims appropriately as necessary. Processes daily and special reports, unlisted invoices and letters, error logs, stalled reports and aging. Reviews previous account documentation, determining appropriate action(s) necessary to resolve each assigned account. Performs outgoing calls to Patients and Insurance companies to obtain necessary information for accurate billing, collections and correction of denials. Answers incoming calls from Insurance companies requesting additional information and/or checking status of claims.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.