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Senior Account Specialist

1 month ago

Sebring, United States AdventHealth Full time

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

• Paid Days Off from Day One • Student Loan Repayment Program • Career Development • Whole Person Wellbeing Resources • Mental Health Resources and Support

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.

Schedule: Full Time - at the Tampa Location

Shift : Days

The community you'll be caring for: AdventHealth Tampa

• AdventHealth Pepin Heart Institute, known across the country for its advances in cardiovascular disease prevention, diagnosis, treatment and research. • Surgical Pioneers - the first in Tampa with the latest robotics in spine surgery • Building a brand new, six story surgical and patient care tower which will ensure state of the art medical and surgical car for generations to come • Awarded the Get With The Guidelines - Stroke GOLD Quality Achievement Award from the American Heart Association/American Stroke Association and have been recognized as a recipient of their Target: Stroke Honor Roll for our expertise in stroke care. We have also received certification by The Joint Commission in collaboration with the American Stroke Association as a Primary Stroke Center.

The role you'll contribute:

Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all. Under the supervision of a Supervisor or Manager, this role is responsible for processing insurance and reimbursement collection efforts in a timely manner by assigned payer of responsibility and performs at a senior level. Reviews assigned electronic claims and submission reports to applicable payers under a specific payer group(s) by high dollar, account age, or any combination thereof to produce the best outcomes. Timely resolves and/or resubmits rejected or denied claims appropriately as necessary or described by Supervisor or Manager. Processes daily, weekly, monthly assigned tasks for assigned special payer assignments, payer aging reports, unbilled or miscellaneous (error) claims which eliminates any barriers for timely reimbursement. Able to maintain a high productivity standard along with additional duties not limited to the following: invoices review and assistance, letters to payers or patients, late charge or error logs, reports and aging. Performs inbound and outgoing calls to patients and/or insurance payers to obtain necessary information for accurate billing and timely reimbursement. Reports any specific issues to Supervisor, Manager or Director to ensure there is proper awareness and a resolution plan to achieve expected outcomes are accomplished. Adheres to all company policies and procedures. Adheres to Florida Hospital Corporate Compliance Plan and to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies.

The value you'll bring to the team:

• Works in collaboration with insurance payers and other revenue cycle departments to ensure proper reimbursement on 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. Assisting the Supervisor with ensuring the day to day operations are smooth and flow easily to meet the expected outcomes. Have comprehensible knowledge in specific contract definitions or matrix to ensure proper reimbursement, educates team of inconsistencies in processing, including disciplinary discussions if necessary, and any changes to contract identified. • Works follow up reports daily, maintaining established goal(s), and notifies Supervisor or Manager of all issues preventing timely reimbursement. Follows up on daily correspondence (denials, underpayments, rejections) 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. • Reviews previous account documentation, determining appropriate action(s) necessary to resolve each assigned account. Initiates next billing, assign appropriate follow-up and/or collection step(s), this is not limited to calling patients, insurers or employers, sends requests to billing for initial or secondary bills to respective team to ensure billing is expedited, etc as appropriate.• Documents billing, follow-up 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 technical, billing appeals, request refunds, reinstatements and rejections of insurance claims with the oversight of the Supervisor and/or Manager. Remains in consistent daily communication with team members, including new process education, disciplinary actions, regarding all aspects of assigned projects. Ensures follow up and follow through is met every 30 days to prevent abandonment.

Qualifications

The expertise and experiences you'll need to succeed:

• High school diploma or GED equivalent. • Three years of work experience in patient accounting, customer service, or collections related area (registration, finance, collections, customer service, medical coding, contract management).