Note: The job is a remote job and is open to candidates in USA. AdventHealth is a healthcare organization seeking an Account Representative III to manage complex revenue cycle and accounts receivable activities. The role focuses on payer contract analysis, denial management, reimbursement resolution, account documentation, compliance, performance monitoring, and mentoring other representatives.
Responsibilities
- Independently manage complex, high-value, and escalated accounts receivable
- Analyze payer contracts and reimbursement methodologies to ensure accurate payment and resolve underpayments
- Lead denial management, appeals, corrected claims, and reimbursement discrepancy resolution
- Perform root cause analysis of denial trends and implement corrective actions to prevent recurrence
- Monitor payer-specific policies, denial patterns, and reimbursement updates to optimize collections
- Serve as the primary contact for payer escalations, audits, projects, and reimbursement issue resolution
- Monitor A/R aging, productivity, KPIs, and reporting to identify performance improvement opportunities
- Prepare detailed account documentation, summaries, and reports for internal and external review
- Resolve complex patient and payer billing inquiries with professionalism, accuracy, and empathy
- Maintain complete, accurate, and compliant account documentation and communication
- Mentor, train, and support Account Representatives while assisting with onboarding and performance feedback
- Conduct quality audits and collaborate with leadership to improve workflows and operational best practices
- Ensure compliance with HIPAA, regulatory requirements, corporate policies, and ethical standards
- Meet departmental productivity, quality, and turnaround expectations while supporting organizational goals
- Perform other duties as assigned
Skills
- * Advanced understanding of end-to-end Revenue Cycle operations, including Patient Access / PreAccess, Health Information Management (HIM), Coding and Charge Capture, Utilization Management, and Patient Financial Services [Required]
- * Strong analytical, problem-solving, and critical-thinking capabilities [Required]
- * Ability to interpret complex payer contracts and reimbursement structures [Required]
- * High-level communication skills (written and verbal) with diverse stakeholders [Required]
- * Proficiency in Microsoft Office (Excel, Word) and revenue cycle systems [Required]
- * Ability to manage multiple priorities in a fast-paced, deadline-driven environment [Required]
- * High School Grad or Equiv [Required]
- * 5+ years of Revenue Cycle experience [Required]
- * Demonstrated experience in Insurance collections, Denial management, Complex account resolution, and Payer interaction [Required]
- * Associates degree [Preferred]
- * Experience with Epic and/or SSI Claims Scrubber [Preferred]
- * Certified Revenue Cycle Rep (CRCR) [Preferred]
Benefits
- Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
- Paid Time Off from Day One
- 403-B Retirement Plan
- 4 Weeks 100% Paid Parental Leave
- Career Development
- Whole Person Well-being Resources
- Mental Health Resources and Support
- Pet Benefits
- Fully Remote
Company Overview