Account Representative Lead Full Time Billing Collections and Denials

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.
• Monitors and assists team members regularly, providing feedback, ensuring both goals and job requirements are met as assigned by Manager. Trains staff performs audits of work performed and communicates progress to appropriate Manager.
• Performs one on one meetings with staff to promote a dedicated team environment.  Provides continuing education to all team members on process and A/R requirements.

EDUCATION AND EXPERIENCE REQUIRED:

·          Three years of experience in a Revenue Cycle department or a related field, such as, registration, finance, collections, customer service, medical, or contract management with a minimum of One- year working collections on HMO, PPO or Government claims

KNOWLEDGE AND SKILLS REQUIRED:

·          Responsive to ever-changing matrix of business needs and acts accordingly

·          Typing skills equal to 30 words per minute

·          Proficiency in performance of basic math functions

·          Communicates 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

·          HCFA1500 formats relative to regulatory standards in claims (paper and/or electronic) processing

·          Excellent knowledge of ICD, CPT, HCPS coding, and medical terminology

The Account Representative Lead is responsible for processing insurance, denials management, billing and collection follow up in a timely manner. Monitors and tracks assigned electronic claims and submission reports. Resolves and resubmits rejected claims appropriately as necessary. Processes daily and special reports, unlisted invoices and letters, error logs, stalled reports and aging. 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. Performs testing for system upgrades/changes.  Provides quality assurance for like job functions when necessary.