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 Florida’s oldest State Park
Close knit community with a home town family feel
2 hours to just about any beach on either Coast
Local arts scene from museums and theaters to festivals and galleries
Local restaurants with the authentic taste of Florida
Near 100+ clear, freshwater lakes. Ideal for swimming, boating and fishing
Beautiful agriculture and farmland
Sebring is known for motorsports and home to the famous Sebring International Raceway
Nature and hiking trails
Work Hours/Shift: PRN as needed
You Will Be Responsible For:
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.
What You Will Need:
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.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.