Insurance Reimbursement Specialist II - Revenue Cycle

Insurance Reimbursement Specialist II - Revenue Cycle Financial - MaitlandFlorida Hospital seeks to hire an Insurance Reimbursement Specialist who will embrace our mission to extend the healing ministry of Christ. Facility Profile:Established in 1908, Florida Hospital is one of the largest not-for-profit healthcare systems in the country, caring for more than a million patients each year. The 2,286-bed acute-care medical facility, comprised of eight hospitals, has been recognized by U.S. News&World Report as one of the best hospitals in the country for the past 10 years. It serves as a community hospital for Greater Orlando and as a major tertiary referral hospital for Central Florida and much of the Southeast, the Caribbean and Latin America. Work Hours/Shifts:Full Time: Monday - Friday 8am - 5pm Job Summary:Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all. Under general supervision, is responsible for processing insurance and billing insurance in a timely manner. Reviews 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. Answers incoming calls from Insurance companies requesting additional information and/or checking status of billings. Adheres to all company policies and procedures. Adheres to Florida Hospital Corporate Compliance Plan and to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies. 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 act accordingly. Ability to communicate 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. 1 year experience in Revenue Cycle Department or related area (registration, finance, collections, customer service, medical, contract management). High school diploma or GED (Preferred) Licensure, Certification, or Registration Required:Non Applicable Job Responsibilities:Demonstrates through behavior Florida Hospital s Core Values of Integrity, Compassion, Balance, Excellence, Stewardship, and Teamwork as outlined in the organization s Performance Excellence Program Works with Insurance payers to ensure proper reimbursement on 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. Examines contract to ensure proper reimbursement, educates team of inconsistencies in processing, including disciplinary discussions if necessary, and any changes to contract identified. 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 payors and patients regarding status of claim, requesting additional information, etc. Reviews previous account documentation, determining appropriate action(s) necessary to resolve each assigned account. Initiates next billing, 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 companies Documents billing, follow-up and/or collection step(s) that are taken and all measures to resolve assigned accounts, including escalation to Supervisor/Manager if necessary. Processes administrative and Medical appeals, refunds, reinstatements and rejections of insurance claims. Remains in consistent daily communication with team members, including new process education, disciplinary actions, Reimbursement Lead and Reimbursement Manager regarding all aspects of assigned projects. Monitors and assists team members regularly, providing feedback, ensuring both goals and job requirements are met as assigned by Manager. Trains new staff, performs audits of work performed, and communicates progress to appropriate Supervisor. Provides continuing education of all team members on process and A/R requirements. Adheres to HIPAA regulations by verifying pertinent information to determine caller authorization level receiving information on account. The above statements reflect the general duties and responsibilities necessary to describe the principal functions of the job, as identified, and shall not be considered an exhaustive list of job responsibilities which may be inherent in the job. Responsibilities are subject to change.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 II opportunity with Florida Hospital and apply online today. Job Keywords:Insurance Reimbursement Specialist, Patient Financial Services,