Raleigh, North Carolina
Texas
Honolulu, Hawaii
Manchester, Connecticut
Durham, North Carolina
Posted: 14-Mar-23
Location: Daytona Beach, Florida
Salary: Open
Internal Number: 23007032
Description
Revenue Cycle Specialist
All the benefits and perks you need for you and your family:
- Benefits from Day One
- 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
Location: 770 W Granada Boulevard Ormond Beach, FL 32174
100% Remote!
The role you’ll contribute:
The Revenue Cycle Specialist will be responsible for follow up on Third Party Claim Reimbursements for the identification, billing and collection of payments. Under the direction of the Manager will be responsible for handling all functions relative to these areas. Responsible for providing support and service to all AHS Facilities in the AdventHealth Central Florida Division – North Region.
The value you’ll bring to the team:
- Responsible for performing and processing accurate billing procedures for all payors, electronically through SSI (a medical claims management system that assists AdventHealth Patient Financial services (FH PFS) insurance reimbursement team with claims editing and validation). Works independently, meeting time and daily deadlines in an accurate and efficient manner, communicating any issues to leadership.
- Ensures expeditious and accurate insurance reimbursement for all Government and Managed Care payors. Updates a high volume of daily claims appropriately in SSI system.
- Monitors and audits status of errors assigned to other areas or PFS teams for all payors daily, ensuring timely follow up and expeditious billing. Communicates with key management staff and supporting department partners effectively and professionally, to ensure key metrics are being addressed timely.
- Maintains communication between external or contracted agencies, business vendors and partners, AH department (i.e. Revenue Management, Laboratory, Contract Management, Case Management, Payors, etc.…) ensuring compliance between external relationships, knowledge of contractual terms, and performance protocols.
- Processes and records agency audit notifications and responds in designated timeframe to ensure compliance with government and/or contractual requirements for timely response.
- Works all assigned insurance payers to ensure proper reimbursement on patient accounts to expedite resolution. Processes medical, administrative, technical appeals, request refunds when applicable, and rejections of insurance claims.
- 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.
The expertise and experiences you’ll need to succeed:
KNOWLEDGE AND SKILLS REQUIRED:
- Computer/data entry skills required. Proficiency in performance of basic math functions. Communicates professionally and effectively, both verbally and in writing
EDUCATION AND EXPERIENCE REQUIRED:
- High School diploma or GED required.
- One-year experience in healthcare, finance, accounting, banking, insurance, billing, or related fields.
- One year of college can be substituted for experience.
