Account Representative( Managed Care Collections) in Tampa, FL for AdventHealth

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.

Work Hours/Shift:

Full Time

You Will Be Responsible For:

Demonstrates through behavior Florida Hospital Tampa Bay Division’s core values of Integrity, Compassion, Balance, Excellence, Stewardship, and Teamwork as outlined in organization’s Performance Excellence Program.

Works all assigned insurance payers to ensure proper reimbursement on patient accounts to expedite resolution. Processes administrative, technical appeals, request refunds when applicable, reinstatements and rejections of insurance claims. Ensures proper escalation is met when account receivable is not collected in a timely manner.
Completes account follow up daily, maintaining established goal (s), and notifies Assistant Supervisor, when necessary, of issues preventing achievement of such goal(s). Ensures our corporate goals are met by consistently keeping our account receivables below our corporate standard.
Analyzes daily correspondence (denials, underpayments) to appropriately resolve issues. Responds to written correspondence received from Payer and/or Patients. Is responsible to stay current on all active, assigned accounts which prevents abandonment, uncollected account receivables.
Assists Customer Service area with patient concerns/questions to ensure prompt and accurate resolution is achieved. Ensures we foster a team-spirited approach while interacting with co-workers, peers, management, etc. Stays committed to delivering superior customer service to our patients.
Analyzes previous account documentation, in order to determine appropriate action(s) necessary to resolve each assigned account. Initiates next billing, follow-up and/or collection step(s), not limited to calling Patients, Insurers or Employers, as appropriate. Remits initial or secondary bills to insurance companies immediately following payment from the primary insurance payer.
Documents the billing, follow-up and/or collection step(s) that are and all measures to resolve assigned accounts, including escalation to Supervisor if necessary. Ensures follow up and follow through are met consistently every 30 days on outstanding account receivables.

Qualifications

What You Will Need:

Three (3) years of knowledge in HMO PPO/Commercial, Medicare or Medicaid/Government payers or business office setting. Uses discretion when discussing personnel/patient related issues that are confidential in nature. Is responsive to ever-changing matrix of hospital needs and acts accordingly. Typing skills equal to 27 words per minute net. Proficiency in performance of basic math functions. Communicates professionally and effectively in English, both verbally and in writing.

Job Summary:

Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all. Under general supervision, is responsible for processing insurance claims, expediting billing and payments for insurance claims. Processes daily and special reports, unlisted invoices and letters, error logs, stalled reports and aging. Performs outgoing calls and correspondence to patients and insurance companies to obtain necessary information for accurate billing. Responds to incoming calls from Insurance companies requesting additional information and/or checking status of billings. Adheres to Adventhealth Corporate Compliance Plan and to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies.

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

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About AdventHealth

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.

Connections working at AdventHealth

More Jobs from This Employer

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