Account Representative III

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

• 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.

• 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]

• Associates degree [Preferred]

• in business or related field

• 5+ years of Revenue Cycle experience [Required]

• Demonstrated experience in Insurance collections, Denial management, Complex account resolution, and Payer interaction [Required]

• Experience with Epic and/or SSI Claims Scrubber [Preferred]

• Certified Revenue Cycle Rep (CRCR) [Preferred]

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse:
https://info.flclearinghouse.com/

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