Insurance Reimbursement Specialist II - Billing - Maitland
Maitland seeks to hire Insurance Reimbursement Specialist who will embrace our mission to extend the healing ministry of Christ.
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 Maitland Office Plaza houses our highly skilled teams that support our hospital system including Marketing, Patient Financial Services, Revenue Management, the Credit Union and Human Resources. The Trickel Building, a two-story office structure, creates an atmosphere of health and healing, with a healthy-style café and quaint chapel. The main lobby is filled with lush greenery and a light trickle of water, creating a holistic environment.
The Medicaid and Government Payors Insurance Reimbursement team at Florida Hospital Maitland includes Billing Representatives, as well as their support and management staff. The Medicaid and Government Payors Insurance Reimbursement department consists of a great team of individuals responsible for collecting all insurance dollars for the services provided to Florida Hospital patients. This is accomplished by making frequent and effective status calls to Medicaid and Government Payors or via online requests. In an effort to resolve outstanding accounts, the Insurance Reimbursement team tracks and trends Medicaid and Government Payor payments in order to provide feedback to Medicaid and Government Payors for improved future performance. This information is often utilized by various departments within Florida Hospital when making operational decisions. We strive to build a working relationship with Medicaid and Government Payors in an effort to create a partnership for success.
Mon – Fri / 8a.m – 5p.m.
Under general supervision, is responsible for processing insurance claims, expediting billing and payments for insurance claims. Processes daily and special reports, unlisted invoices and letters, error logs, stalled reports and aging. Performs outgoing calls and correspondence to patients and insurance companies to obtain necessary information for accurate billing. Responds to incoming calls from insurance companies 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. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all..
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 acts accordingly
Ability to communicate professionally and effectively in English, both verbally and in writing
Licensure, Certification, or Registration Required:
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 payors to ensure proper reimbursement on patient accounts to expedite resolution. Processes administrative appeals, refunds, reinstatements and rejections of insurance claims.
Completes account follow up daily, maintaining established goal (s), and notifies Lead Rep, when necessary, of issues preventing achievement of such goal(s).
Analyzes daily correspondence (denials, underpayments) to appropriately resolve issues. Responds to written correspondence received from Payor and/or Patients.
Assists Customer Service area with patient concerns/questions to ensure prompt and accurate resolution is achieved.
Analyzes previous account documentation, in order to determine appropriate action(s) necessary to resolve each assigned account. Initiates next billing, follow-up and/or collection step(s), not limited to calling Patients, Insurers or Employers, as appropriate. Remits initial or secondary bills to insurance companies.
Documents the billing, follow-up and/or collection step(s) that are and all measures to resolve assigned accounts, including escalation to Supervisor if necessary.
Remains in consistent daily communication with Insurance Reimbursement Supervisor and Lead Insurance Reimbursement Specialist regarding all aspects of assigned projects.
Adheres to HIPAA regulations by verifying pertinent information to determine caller authorization level receiving information on account
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 opportunity with Maitland and apply online today.
Florida Hospital is dedicated to improving lives not only in Central Florida, but also around the world. As a destination hospital, we are committed to serving the health care needs of our patients with a holistic approach to ...heal the mind, body and spirit. We strive to be the hospital of choice for patients, physicians and employees. Over the last 100 years, Florida Hospital’s mission remains unchanged: to extend the healing ministry of Christ.