Global Accounts Manager Managed Care AdventHealth Corporate
Location Address: 1051 Winderley Place Suite 400 Maitland, FL 32751
Top Reasons To Work At AdventHealth Corporate
Immediate Health Insurance Coverage
Career growth and advancement potential
Full-Time, Monday â“ Friday
You Will Be Responsible For:
Sets up and maintains patient files for the Global Network accounts in within expected timeframes of notice of a new patient.
Uses, loads and maintains information and coverage in systems such as Cerner, OTTR, Sunport, Availity, DDE, payer web sites etc.
Updates and disseminates critical patient account information to internal and external customers such as Florida Institute for Cellular Therapy, Florida Hospital Transplant Institute, PFS and other treating providers.
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.
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.
Manages the establishment of vendors such as physician groups, other providers and payers.
Supports the growth and expansion of the transplant programs. Researches and communicates transplant reimbursement knowledge to team, leadership and interested parties within the organization.
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.
What You Will Need:
Three years in healthcare or insurance
Bachelorâ™s degree preferred.
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.
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.
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.