Payment Integrity Representative

HealthFund Solutions LLC•Orlando, FL

About The Position

At HealthFund Solutions, we are an advocate for the uninsured and the underinsured patients and a partner to hospitals and healthcare providers. With decades of experience in the healthcare field, we observed a rising need to help a percentage of the population that continues to grow every day—those living without health insurance. Through sponsorship programs, Medicaid screening and premium monitoring, we empower patients to get the coverage and care they need to get back on their feet. Reporting to our Payment Integrity Manager, the Payment Representative acts as a liaison between our patients and their insurance companies. Prior experience with insurance technology, medical background, and payment management of accounts.

Requirements

High School Diploma required
Organized
Extreme Attention to Detail
Process Initiative
Ability to communicate effectively in speaking and writing
Work effectively with individuals from diverse backgrounds
Ability to establish and maintain effective working relationships
Ability and desire to communicate effectively by telephone
Perform basic operations in Microsoft Office Suite
Three (3) to five (5) years of related experience in medical billing or accounting is preferred
NOTE: This job description is not intended to be all-inclusive. Employee may perform other duties as required to meet the ongoing needs of the organization.
Please note that as we are vendors to several hospital systems. All onsite hospital positions are required to have the COVID vaccination completed prior to start date. If you choose not to vaccinate, you are required to provide a fully executed medical or religious exemption form prior to your start date. Upon approval of that exemption, you would be required to submit to weekly COVID testing. Be aware, that this policy could change at any time.
We are an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.
The successful candidate will be required to complete the Form I-9 and that information will be verified using the E-Verify system. E-Verify is operated by the Department of Homeland Security in partnership with the Social Security Administration to verify employment eligibility.
Any candidate offered a position will be required to pass pre-employment screenings which include a national background check and a 12-panel drug screen. HealthFund Solutions is a Drug -Free Workplace.

Nice To Haves

College Degree or some college preferred
General Accounting experience is helpful
Prior experience in medical insurance invoicing and payment management of accounts is helpful

Responsibilities

Interact with Company departments and external vendors
Send, receive, and review contracts with external vendors
Update Company databases, with extreme attention to detail
Work in compliance with banking portals
Verify Insurance information on patient account for accuracy and contract compliance
Assist in making patient insurance premiums payments
Accurately record payments made in company database per outlined procedures
Review exception reports
Actively pursue refunds owed by insurance companies
Maintains accurate and organized patient files (both paper and electronic versions)
Other duties as assigned