Insurance Reimbursement Specialist – Billing/FHL – Maitland

Florida Hospital Eustis, FL 2019-01-08

Insurance Reimbursement Specialist – Billing/FHL – Maitland

AdventHealth Maitland seeks to hire an Insurance Reimbursement Specialist who will embrace our mission to extend the healing ministry of Christ.

Facility Profile:

Established in 1908, AdventHealth is one of the largest not-for-profit healthcare systems in the country, caring for more than a million patients each year. The Maitland Office Plaza houses our highly skilled teams that support our hospital system including Marketing, Patient Financial Services, Revenue Management, the Credit Union and Human Resources. The Trickel Building, a two-story office structure, creates an atmosphere of health and healing, with a healthy-style café and quaint chapel. The main lobby is filled with lush greenery and a light trickle of water, creating a holistic environment.

Work Hours/Shifts:

Monday through Friday; 8a – 5p

Job Summary:

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. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

Knowledge, Skills, Education, & Experience Required:

  • Ability to use discretion when discussing personnel/patient related issues that are confidential in nature.
  • Ability to be responsive to ever-changing matrix of hospital needs and acts accordingly.
  • Ability to communicate professionally and effectively in English, both verbally and in writing.
  • High school diploma or GED (Preferred)

Licensure, Certification, or Registration Required:

  • N/A

Job Responsibilities:

Demonstrates through behavior AdventHealthl’s Core Values of keep me safe, Love me, Make it easy, and own it as outlined in the organization’s Performance Excellence Program
  • Works with Insurance payors to ensure proper reimbursement on patient accounts to expedite resolution. Processes administrative appeals, refunds, reinstatements and rejections of insurance claims.
  • Completes account follow up daily, maintaining established goal (s), and notifies Lead Rep, when necessary, of issues preventing achievement of such goal(s).
  • Analyzes daily correspondence (denials, underpayments) to appropriately resolve issues. Responds to written correspondence received from Payor and/or Patients.
  • Assists Customer Service area with patient concerns/questions to ensure prompt and accurate resolution is achieved.
  • 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.
  • 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.
  • Remains in consistent daily communication with Insurance Reimbursement Supervisor and Lead Insurance Reimbursement Specialist regarding all aspects of assigned projects.
  • Adheres to HIPAA regulations by verifying pertinent information to determine caller authorization level receiving information on account.
If you want to be a part of a team that is dedicated to delivering the highest quality in patient care, we invite you to explore the Insurance Reimbursement Specialist opportunity with AdventHealth Maitland and apply online today.
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