Service Rep I Collector PRN (Full- Time) AdventHealth Sebring
Location Address: 4200 Sun 'n Lake Boulevard Sebring, FL 33872
Top Reasons to Work at AdventHealth Sebring
Faith Based & Mission driven Facility
Largest Employer in the County
Surrounded by beautiful Lakes, Golf Courses and Floridaâ™s oldest State Park
Close knit community with a home town family feel
2 hours to just about any beach on either Coast
Work Hours/Shift: PRN
You Will Be Responsible For:
PRINCIPAL DUTIES AND JOB RESPONSIBILITIES:
Review and resolve encounters assigned via CPA work list daily using tools such as DDE, SSI, Discern Notify, Payer Websites, etc.
File an appeal on unwarranted denials of non-contracted carriers within 48 hours of notification when appropriate.
Ensure eScan and other vendor worklist are worked in accordance with department guidelines.
Review and respond to mail received within 48 hours from receipt.
Maintain days in AR for all books of business according to the departments yearly goals. Ensuring the department maintains all outgoing bills meet billing guidelines according the various contracts.
Ensuring when insurance is added to an encounter we have obtained the appropriate authorizations prior to submitting the bill to the payer when appropriate.
Assure all claims are filed correctly and are in compliance with billing guidelines set forth by State, Federal and local statues. Know and enforce all Medicare rules and regulations through updates and bulletins. Review the Medicare web site on a monthly basis when appropriate.
Contribute to a positive working environment by showing inter/intra departmental respect towards co-workers. Work with outside providers, patients, and intermediaries in a professional courteous manner to maintain excellent customer relations.
File supplemental claims within 48 hours of the receipt of the primary payment or denial when appropriate.
File the supplemental claim twice before making them patient responsibility when appropriate.
Other duties as assigned.
What You Will Need:
Strong organizational skills
Strong keyboard and 10 key skills
KNOWLEDGE AND SKILLS PREFERRED:
Prior hospital or physician billing background
Knowledge of billing rules and regulations
EDUCATION AND EXPERIENCE REQUIRED:
A minimum of a High School diploma or equivalent
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 claims, expediting billing and payments for insurance claims. Performs outgoing calls and correspondence to patients and insurance companies to obtain necessary information for accurate billing. Utilizes the Discern Notify tool to communicate with other departments regarding any necessary updates to ensure an accurate claim. Responds to incoming calls requesting additional information and/or checking status of billings. Adheres to Florida Hospital Corporate Compliance Plan and to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies.
AdventHealth Greater Orlando (formerly Florida Hospital) is one of the largest faith-based health care providers in the United States. For 150 years, we have carried on a tradition of providing whole-person care that not only addresses patients' physical ailments, but also supports their emotional and spiritual well-being. We demonstrate the same level of compassion and care for our employees as well, doing all that we can to help them realize their full potential – both personally and professionally.