Patient Accounts Spec II

Position Summary

At Orlando Health, 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 reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities.

Responsibilities

• Resolves inaccurate payments with insurance carriers that are not in compliance with payer contracts or governmental agency rates on individual accounts.
• Utilizes specialized knowledge of contracts, regulatory or contractual billing guidelines to determine an account’s ability to pay after initial rejection from payer.
• Collaborates with payer contracting and other areas of the revenue cycle, if necessary, to resolve issues pertaining to a claim payment.
• Communicates directly with payers to follow up on outstanding claims and resolve payment variances, responds to payer inquiries and concerns, and works to develop and maintain positive relationships with payers.
• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state, and local standards.
• Maintains compliance with all Orlando Health policies and procedures.

Qualifications

• High School diploma or GED required.
• Must complete Orlando Health team member development within 6 months of hire date.
• Works efficiently with Microsoft applications (Outlook, Word, Excel, PowerPoint).
• HFMA Certified Revenue Cycle Representative (CRCR) certification received within six (6) months.
• One (1) year experience as a Patient Accounts Specialist I or Minimum of two (2) years’ experience in a related field (medical billing/collections/managed care).
• Assists Patient Accounting Rep III with the planning and organizing of departmental activities as needed.
• Responsible for account follow-up for all assigned accounts.
• Maintains system work queues based on electronic payers' error reports as assigned including but not limited to DNB, Claim Edits, Front End Rejections, and No Response from payers, Variances, underpayments, overpayments.