Accounts Receivable Specialist

Job DetailsJob Location: Kissimmee, FL 34741Position Type: Full TimeABOUT US: At Park Place Behavioral Health Care, we've been leading the way in mental health and substance use disorder services since 1976. As a multi-site facility, we provide a full spectrum of innovative behavioral health services tailored to meet the needs of both inpatient and outpatient clients.   We're more than just a workplace.  We’re a mission-driven community dedicated to improving lives. Every member of our team plays a vital role in empowering individuals and families to achieve wellness, live self-directed lives, and reach their full potential. Join our team of over 300 passionate professionals and become part of something meaningful.   We’re proud to foster a diverse, inclusive, and respectful environment where every voice matters. We know that embracing different backgrounds and perspectives not only strengthens our culture but also enhances the care we provide.   WHY WORK WITH US?: We offer more than just a job.  We offer growth, balance, and the opportunity to make a difference.   Our benefits include: Paid Time Off & Holiday Pay Medical, Dental, and Vision Insurance Basic Life and AD&D Insurance Short-Term Disability Flexible Spending Accounts 401(k) Retirement Plan FMLA Leave Ongoing Training & Development Flexible Work Options (Full-time, Part-time, Contract) Career Advancement Opportunities   With 50 years of service in the community, Park Place Behavioral Health Care is a trusted leader with stability, flexibility, and purpose. ABOUT THE ROLE:   SUMMARY: Manage outstanding insurance and individual account balances to secure timely payments.   SUPERVISORY RESPONSIBILITIES: N/A   ESSENTIAL DUTIES AND RESPONSIBILITIES: The Duties and Responsibilities reflect the general details considered necessary to describe the principal functions of the job and shall not be construed as a detailed description of all related work assignments that may be inherent to the job. Perform end-to-end denial management, including researching claim denials, identifying root causes, submitting appeals, and securing appropriate reimbursement. Analyze denial patterns and reimbursement trends to identify opportunities for process improvement and revenue recovery. Contact insurance carriers via phone, email, payer portals, and written correspondence to resolve claim issues and payment delays. Investigate and resolve claim edits, rejections, authorization issues, coding discrepancies, and payer-specific reimbursement concerns. Follow up on aged accounts and claims with no response from insurance carriers. Review and apply current federal, state, Medicare, Medicaid, and payer-specific regulations. Handle Electronic Data Interchange (EDI) transactions, including reconciliation of carrier submissions, clearinghouse edits, and rejection reports. Reconcile accounts, post incoming payments, and handle adjustments accurately. Answer individual billing questions, set up and maintain payment plans, and resolve balances. Maintain confidentiality of organizational information and adhere to all HIPAA guidelines and regulations. Performs other duties as required by Supervisor. QualificationsQUALIFICATIONS, EDUCATION AND/OR EXPERIENCE: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. High School Diploma and one to three years of hands-on experience in medical billing, collections, or revenue cycle management. Familiarity with electronic health records, medical billing software, and strong Microsoft Excel skills. Understanding of ICD-10/CPT coding, insurance guidelines, and HIPAA rules. Understanding of insurance reimbursement processes, claim adjudication, Medicare, Medicaid, and commercial payer requirements. Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.   REQUIREMENTS: A valid Class E Drivers’ License for positions that require driving personal or Agency vehicle on Agency business. Must maintain a minimum Bodily Injury & Property Liability insurance limit of at least $50,000 for positions that require driving personal own vehicle (POV) on Agency business. (Proof Required) PPBH is a 24/7 Agency.  All employees must be available as needed when required.   PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position.  Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.   While performing the duties of this job, the employee is regularly required to stand, walk, sit, talk, hear, and use hands to finger, handle, or feel objects, tools, or controls. The employee will occasionally lift and/or move up to 25 pounds.  Specific vision abilities required by this job include close vision, distance vision, depth perception, and the ability to adjust focus.    WORK ENVIRONMENT: The work environment characteristics are representative of those an employee encounters while performing the essential functions of this job.  The noise level in the work environment is usually moderate in a fast paced work environment. If this sounds like you, we invite you to apply.  We can’t wait to meet you! We are an equal opportunity employer, and we are committed to providing equal employment opportunities to all employees and applicants.  We also participate with the Florida Care Provider Background Screening Clearinghouse for all employment backgrounds.  Please refer to this link for more information: https://info.flclearinghouse.com  If you require reasonable accommodation during the application or interview process, please contact our HR Department at 407-846-0023.