Global Accounts Manager Managed Care at AdventHealth

Date Posted: 11/18/2019

Job Snapshot

  • Job Schedule
    Full-Time
  • Location:
    Maitland, FL
  • Job Category
  • Date Posted:
    11/18/2019
  • Job ID:
    19021251
  • Job Family
    Managed Care
  • Travel
    No
  • Shift
    1 - Day
  • Application Zone
    1-Shared Services
  • Organization
    AdventHealth Corporate

Job Description


Description
Location Address: 1051 Winderley Place Maitland, Fl 32751

Top Reasons To Work At AdventHealth Corporate

  • Great benefits
  • Immediate Health Insurance Coverage
  • Career growth and advancement potential
Work Hours/Shift:
  • Full-Time, Monday – Friday

You Will Be Responsible For:

PATIENT ACCOUNT SET UP AND MAINTENANCE-15%

  • Sets up and maintains patient files for the Global Network accounts in within expected timeframes of notice of a new patient.
  • Retrieves information on patient services, benefits, coverage, etc. as necessary to perform assigned duties.

INVOICING/BILLING PAYERS AND TRACKING PAYER REIMBURSEMENTS-15%

  • Accurately assesses appropriateness of all incoming provider claims and documents in patient account spreadsheets.
  • Accurately and within contractual timely filing terms submits claims (invoicing/billing) to payer or payer network.
  • Ensures payer payment is made within contractual or regulatory timeframes.

PAYMENT PROCESSING TO GLOBAL NETWORK PROVIDERS-10%

  • Validates reimbursement to providers in accordance with provider Agreements.
  • Prepares Explanation of Benefits along with payment to providers in accordance with contractual and regulatory timeframes for provider payment.

INTERNAL AND EXTERNAL COMMUNICATION AND SUPPORT-10%

  • Effectively communicates with staff, leadership, payers, providers, and, as applicable, with patients in a professional and courteous manner.
  • Coordinates and facilitates meetings with internal partners such as other Managed Care teams, Florida Institute for Cellular Therapy, Florida Hospital Transplant Institute, PFS and other Florida Hospital departments to provide a forum and effectively discuss and resolve issues and share information.

FINANCE AND ACCOUNTING-10%

  • Accurately and timely closes patient accounts, balancing all revenue and expenses.
  • Accurately and timely documents all information in summary sheets.
  • Manages the establishment of vendors such as physician groups, other providers and payers.

CONTRACTS AND LETTERS OF AGREEMENT-8%

  • Has extensive knowledge of payer and provider contractual terms for operations and reimbursement.
  • Serves as liaison and provider relations representative between payers and providers in relation to operational and reimbursement terms of the payer and provider contracts.
  • Ensures contract information is accurately and timely updated on spreadsheets, contract files and databases.
  • Communicates and recommends improvement of payer and provider contract terms to Manager and Director.
CONFIDENTIALITY-12%
  • Deals discretely with confidential information concerning AHS’s affairs and documents.  Releases confidential information only with approval from leader(s) with no exceptions.  Refrains from discussing business with those who do not have a need to know.
  • Complies with corporate confidentiality procedures.
 

Qualifications
What You Will Need:
  • Three years in healthcare or insuranc
  • Specific training or experience in Managed Care, Patient Financial Services, Accounting or Provider Relations
  • Strong organizational and communications skills, ability to identify, analyze, articulate and solve issues regarding patient accounts, ability to take initiative, ability to troubleshoot issues, and develop timely and practical solutions for both internal and external operations.
  • Personal Computer, general office equipment such as phone, fax, scanner, copy machine
Job Summary:

This position is responsible for the review, negotiation, and implementation of global contracts for providers in the FHHS Global Network.  Ensures that all global billing and follow-up is done in a timely fashion and maintains a close working relationship with various internal and external departments and agencies. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.



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

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