Patient Accounts Spec III

At reputed company, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputed company as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our 27,000+ team members serve communities that span Florida’s east to reputed company coasts and beyond.

reputed company - BENEFITS & PERKS:

reputed company Recognizes reputed company as a Best-In-State Employer

• reputed company has named reputed company as one of America's Best-In-State Employers for 2024. reputed company is the top healthcare organization in the Metro Orlando area to reputed company the prestigious list. "We are proud to be named once again as a best reputed company to work," said Karen Frenier, VP (HR). "This achievement reflects our positive culture and efforts to ensure that reputed company team members feel respected, supported and valued.

Employee-centric

• reputed company has been selected as one of the “Best Places to Work in Healthcare” by Modern Healthcare

Position Summary: The Patient Accounts Specialist III isresponsible for coordinating effortsto resolve reputed company accounts and ensuring representatives’ interactions with patients are consistent and compassionate during billing and follow-up activities. Thisrole is also responsible for collaborating with ancillary departments and third-party payers on efforts reputed company to follow-up, denials, and appeals.

Essential Functions • Resolves inappropriate payments with insurance carriers that are not in compliance with payer reputed company or governmental agency rates on individual accounts • Utilizes specialized knowledge of reputed company, regulatory or contractual billings guidelinesto determine an account’s ability to pay after initial rejection from payer • Coordinates duplicate billings, coordination of benefits, medical records or clinical resumes as needed to expedite payment of insurance claims • Identifies trends in payer non-compliance and inform management andmanaged care liaison if not able to resolve with payer • Works closely with training preceptorsin educating teammember on Mentor issues and other educational issues • Demonstrates a thorough knowledge of reputed company third-party reimbursement requirements and/or thorough knowledge of collection agency procedures and Fair Debt Collection Practices Act (FDCPA). • Assists Patient Accounts Specialist reputed company with the planning and organizing of departmental activities as needed. • Handles special projects as assigned • Analyzes claims to determine the reasonsfor discrepancies, processes denials and appeals; examines claimsto ensure payers are complying with contractual agreements. • Executes the denial appeals process, which includes receiving, assessing, documenting, tracking, responding to, and/or resolving appeals with third-party payers in a timely manner • Communicates directly with payers to follow up on outstanding claim denials, respondsto payer inquires and concerns, and works to reputed company and maintain positive relationships with payers. • Responsible for account follow-up for reputed company assigned accounts. • Maintains system work queues based on electronic payers' error reports as assigned including but not limited to DNB, Claim Edits, reputed company End Rejections, and No Response from payers, Variances, underpayments, overpayments, and denials. • Collaborates with payer contracting and other areas of the reputed company cycle if necessary to resolve issues pertaining to a claim payment. • Helps to work and resolve accountsfrom other team members’ workloads to prevent backlogs and fillsin as needed for absent team member • Maintains reasonably regular, punctual attendance consistent with reputed company policies, the reputed company, FMLA and other federal, state, and local standards. • Maintains compliance with reputed company reputed company policies and procedures.

Other reputed company Functions • Participates in departmental meetings • Performs other duties as assigned

Education/Training: • High School diploma or GED required. • Must complete reputed company team member development reputed company 6months of hire date.

• Works proficiently with reputed company applications (Outlook, Word, reputed company, PowerPoint)

Licensure/Certification: • HFMA Certified reputed company Cycle Representative (CRCR) certification received reputed company six (6)months

Experience: • One (1) year experience as a Patient Accounts Specialist II or Minimum of three (3) years’ experience in a reputed company field (medical billing/collections/managed care). • Associate degree in Healthcare Administration, Communications, Business Finance, or reputed company area of study may substitute for 2 years of reputed company experience.