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Patient Financial Representative II
Location Address: 2415 N Orange Ave Suite 700
Top Reasons to work at AdventHealth
Career growth and advancement potential
Full time hours with Benefits
Conveniently located near i-4
We have Positive values with a productive and energetic atmosphere
Work Hours/Shift: Full Time/Days Monday- Friday
PRINCIPAL DUTIES AND JOB RESPONSIBILITIES:
Demonstrates, through behavior, Florida Hospital’s core values of Integrity, Compassion, Balance, Excellence, Stewardship, and Teamwork
* Delivers excellent customer service to the patients/families and other care providers, focusing on family-centered care by displaying a positive attitude and demonstrates a professional demeanor with every patient encounter.
* Performs general tasks related to insurance verifications and authorizations for office visits, surgeries and diagnostic testing. Accurately completes all associated documentation required for billing purposes. Determine patient’s financial responsibilities as stated by insurance and negotiate singe case agreements with non-contracted health plans as necessary. Performs and assists the Assistant Director with utilization reviews, medical necessity and appeals.
* Serves as informational resource to patients with contracted and non-contracted insurances. Provide education or information about the governmental insurance exchange(s) and assisting patients as necessary with questions related to their available benefit choices. Meet with patients as necessary for translation and/or explanation services.
* Performs general tasks related to charge capture and billing documentation. Ensure providers accurately complete and submit E&Ms with the schedule and/or bed census. Update encounter forms for all practices with new billing codes (ICD 9, ICD 10, CPT and DX codes). Serve as liaison between the billing service and the providers regarding billing related concerns.
* Establish and maintain a working relationship with key contacts at insurance companies and other departments in Florida Hospital.
* Assists with on-going billing related training and professional development of providers as directed by the Assistant Director. This includes new physician on-boarding training and other training.
* Reviews physician and physician extenders documentation to code and bill for professional services provided. Responsible for validation of ICD-9, ICD-10, CPT and HCPCS codes as submitted by providers in addition to performance of assigning codes as deemed necessary from the review of the providers documentation.
* Prepares and disseminates various reports to the Assistant Director or others including, but not limited to, reports related to the submission of charges, delayed charges, and delayed dictation and volume reports for validation of provider RVU reports.
* Participates in special projects to improve quality and efficiency in an effort to improve the patient experience of care including quality and satisfaction, improve the health of the populations served and reduce the cost of clinic care.
* Assists with the on-boarding, training and professional development of the Level I Patient Financial Representatives, provides education, support and verifies competence of the staff he/she mentors.
* Maintains current knowledge of Medicare and Medicare rules, including any legislation affecting the transplant patients.
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.
EDUCATION AND EXPERIENCE REQUIRED:
· Four years’ experience in a complex healthcare setting with primary responsibility of providing full financial work-up and financial reimbursements
KNOWLEDGE AND SKILLS REQUIRED:
· Able to communicate effectively both verbally and in writing in English with patients, staff, and customers of varied backgrounds in a respectful, effective, and professional manner
· Strong interpersonal, organizational skills and the ability to work effectively in an environment with frequent interruptions
· Able to act in an autonomous, self-directed manner while maintaining the ability to collaborate with other professionals and non-professionals in situations of high complexity and high intensity
· Self-motivated, with the ability to multi-task and adapt to changing demands
· Mature judgement and the ability to handle confidential information within AdventHealth guidelines and applicable regulations
· Knowledge of clinical documentation, exam procedures and protocols
· Proficiency using personal computer, word processing and email system. Must have knowledge of Microsoft Excel and Microsoft Word
· Understanding of CPT codes and ICD 9/ICD 10 coding
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.