Job Information

AdventHealth Global Accounts Manager Managed Care in Maitland, Florida

Description

Global Accounts Manager Managed Care AdventHealth Corporate

Location Address: 1051 Winderley Place Suite 400 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:

  • 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.

Qualifications

What You Will Need:

  • Three years in healthcare or insurance

  • Bachelor’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.

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.

Category: Managed Care

Organization: AdventHealth Corporate

Schedule: Full-time

Shift: 1 - Day

Travel: AdventHealth

Req ID: 20022849

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.