Position Summary
The Patient Accounts Specialist II is responsible for promoting accurate reimbursement for the organization by ensuring timely and
accurate billing and collection of accounts. This individual identifies and analyzes payment variances to enact and effectively
communicate corrective measures that resolve payer errors.
Essential Functions
* Resolves inaccurate payments with insurance carriers that are not in compliance with payer contracts or governmental agency rates
on individual accounts.
* Utilizes specialized knowledge of contracts, regulatory or contractual billing guidelines to determine an account's ability to pay after
* initial rejection from payer.
* Coordinates duplicate billings, coordination of benefits, medical records and clinical documents as needed to expedite payment of
insurance claims.
* Assists Patient Accounting Rep III with the planning and organizing of departmental activities as needed.
* Analyzes underpayments and overpayments to identify root causes and examines claims to ensure payers are complying with
contractual agreements.
* Collaborates with payer contracting and other areas of the revenue cycle if necessary, to resolve issues pertaining to a claim
payment.
* Communicates directly with payers to follow up on outstanding claims and resolve payment variances, responds to payer inquires
and concerns, and works to develop and maintain positive relationships with payers.
* Helps to work and resolve accounts from other staff members' workloads to prevent backlogs and fills in as needed for absent staff
* Assists Patient Accounting Rep III with the planning and organizing of departmental activities as needed.
* Responsible for account follow-up for all assigned accounts.
* Maintains system work queues based on electronic payers' error reports as assigned including but not limited to DNB, Claim Edits,
Front End Rejections, and No Response from payers, Variances, underpayments, overpayments.

***Fully Onsite in Orlando, FL***

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.