Accounts Receivable Representative, Physician & Professional Services - Wesley Chapel

Orlando Health•Wesley Chapel, FL

About The Position

Works as a part of the team which is responsible for facilitating the timely collection of monies owed to the organization.

Requirements

High School graduate or GED required.
Must complete staff development within the 6 months of hire date.
One (1) year experience in related field (medical billing/collections/managed care) required.
Knowledge of Microsoft Office Excel and Word required.
Ability to type 30 wpm.

Responsibilities

Thorough knowledge of multi-specialty ICD-9 and CPT coding.
Telephone insurance carrier/patient to seek resolution on account.
Resolve inappropriate payments with insurance carriers that are not in compliance with payer contracts or governmental agency rates on individual accounts.
Utilize specialized knowledge of contracts, regulatory or contractual billings guidelines to determine an account’s ability to pay after initial rejection from payer.
Coordinate duplicate billings, coordination of benefits, medical records or clinical documents as needed to expedite payment of insurance claims.
Identify trends in payer non-compliance and inform management if not able to resolve with payer.
Negotiate within specified guidelines with payers.
Ensure secondary carrier is appropriately billed or self-pay portion is pursued.
Determines an individual’s ability to pay and seeks additional assistance either through governmental programs or uncompensated care programs.
Follows up with appropriate staff to locate missing information.
Ensures accurate and timely billing of all outstanding account balances to the appropriate third party payers and patient guarantors.
Maintains necessary logs.
Responsible for answering telephone calls is area when needed.
Assist Physician & Professional Services A/R Representative III with the planning and organization of departmental activities as needed.
Participate in departmental meetings as necessary.
Seek to gain needed knowledge and experience to promote to Physician & Professional Services Accounts Receivable Representative III.
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.
Perform other related duties as needed.