PFS/Account Rep (Managed Care Collection) FT/Day in Tampa, FL at Florida Hospital Tampa

Date Posted: 7/26/2018

Job Snapshot

  • Job Schedule
  • Location:
    Tampa, FL
  • Job Category
  • Date Posted:
  • Job ID:
  • Job Function
    Patient Financial Services
  • Travel
  • Shift
    1 - Day
  • AHS Zone
    1-Shared Services
  • Organization
    Florida Hospital Tampa

Job Description

Work Hours/Shift
     FT / Day
Florida Hospital Tampa

Our hospital has celebrated many firsts in Tampa’s health care history since we opened our doors in 1968. Today, more than four decades later, Florida Hospital Tampa continues to offer innovative medicine as we elevate health care in the Tampa Bay region.

At Florida Hospital Tampa, our diverse clinical specialties provide world-class health care to our patients. We offer the most trusted, expert care in key specialties including cardiovascular care, neurosciences, orthopedics, women's health, cancer and surgery. Our skilled surgeons not only utilize minimally invasive and robot-assisted procedures, but they are also leaders in improving these advanced techniques.

You will be responsible for:
  • Works all assigned insurance payers to ensure proper reimbursement on patient accounts to expedite resolution. Processes administrative, technical appeals, request refunds when applicable, reinstatements and rejections of insurance claims.  Ensures proper escalation is met when account receivable is not collected in a timely manner.
  • Completes account follow up daily, maintaining established goal (s), and notifies Assistant Supervisor, when necessary, of issues preventing achievement of such goal(s).   Ensures our corporate goals are met by consistently keeping our account receivables below our corporate standard.
  • Analyzes daily correspondence (denials, underpayments) to appropriately resolve issues. Responds to written correspondence received from Payer and/or Patients.  Is responsible to stay current on all active, assigned accounts which prevents abandonment, uncollected account receivables.
  • Assists Customer Service area with patient concerns/questions to ensure prompt and accurate resolution is achieved. Ensures we foster a team-spirited approach while interacting with co-workers, peers, management, etc.  Stays committed to delivering superior customer service to our patients.
  • 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 immediately following payment from the primary insurance payer.
  • 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.  Ensures follow up and follow through are met consistently every 30 days on outstanding account receivables. 
  • Remains in consistent daily communication with Insurance Collections Supervisor and Assistant Supervisor regarding all aspects of assigned projects, reports and requests.  Knowledge in managed care contracting matrix for the payment methodologies.
  • Adheres to HIPAA regulations by verifying pertinent information to determine caller authorization level receiving information on account
What will you need?
  • Three (3) years of knowledge in HMO PPO/Commercial, Medicare or Medicaid/Government payers or business office setting. 
  • Uses discretion when discussing personnel/patient related issues that are confidential in nature. 
  • Is responsive to ever-changing matrix of hospital needs and acts accordingly.
  • Typing skills equal to 27 words per minute net. 
  • Proficiency in performance of basic math functions.
  • Communicates professionally and effectively in English, both verbally and in writing.
  • High school diploma or GED

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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