State of Florida
Overview
ACCOUNTANT III at the Florida Department of Health, Broward. This on-site position is part of the Finance-Billing team within the Accounts Receivable Department and involves hospital/clinic medical and dental billing, coding support, and related financial processes. Responsibilities
Payment Posting: post Explanation of Benefits (EOB) from insurance companies in HMS; ensure reimbursement is the correct allowable amount; maintain daily posting payment reports in Excel. Audits and Processes Encounters: assist in auditing superbills, verify insurance information, research claims (Medicaid and other third-party carriers), and re-evaluate claims as needed; participate in vendor training. Reports and Analysis: run and prepare daily reports for supervisor; maintain a daily Issues Report; analyze department denials to identify patterns and trends; inform supervisor of issues impacting payment. Claims Billing: ensure accuracy and timeliness of medical and dental billing; capture correct charges; perform HMS billing portal tasks and related file maintenance. Denials, Appeals, and Collections: audit EOBs, process appeals, maintain an insurance follow-up log, and follow up with plans to collect on denied or partially paid claims; document denials in HMS and escalate as needed. Credentialing and Enrollment: manage provider credentialing/enrollment; monitor NPI, DEA, Medicaid enrollment renewals, and related documentation. Write-Offs and Collections: write-off balances >120 days; apply waivers per policy with proper approvals. Ryan White Program Billing: assist with Ryan White Part A dental invoicing and Medicaid billing; monitor dental encounters in PE and HMS; prepare monthly invoices for Ryan White services. Clinic Training and Support: provide billing training to clinic staff; offer FMMIS training; assist with coding and encounter input at clinics. Other duties as assigned. Minimum Qualifications
Willing to work before, during, and/or beyond normal hours in emergencies. Current Florida Department of Health employee (OPS, Career Service, SES or SMS). Data entry experience. Experience evaluating medical/dental insurance eligibility. At least 1 year of customer service experience in a clerical or cashier role within the past 3 years. Preferred Qualifications
At least 2 years of health insurance claims processing within the past 3 years. Associate degree or higher from an accredited college or university. Current CPC certification. Additional Information
This position requires on-site work in Broward County. Applicants must apply via People First; no faxed or mailed applications. Applicants to provide verifiable information through the electronic application. Qualifying questions must be supported by documentation in the application. A security background check and/or drug screening, E-Verify, and direct deposit participation are required. The State of Florida is an Equal Opportunity Employer. Equal Opportunity and Veterans’ Preference
Veterans’ Preference applies per Florida statutes; documentation must be provided with submission as required.
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ACCOUNTANT III at the Florida Department of Health, Broward. This on-site position is part of the Finance-Billing team within the Accounts Receivable Department and involves hospital/clinic medical and dental billing, coding support, and related financial processes. Responsibilities
Payment Posting: post Explanation of Benefits (EOB) from insurance companies in HMS; ensure reimbursement is the correct allowable amount; maintain daily posting payment reports in Excel. Audits and Processes Encounters: assist in auditing superbills, verify insurance information, research claims (Medicaid and other third-party carriers), and re-evaluate claims as needed; participate in vendor training. Reports and Analysis: run and prepare daily reports for supervisor; maintain a daily Issues Report; analyze department denials to identify patterns and trends; inform supervisor of issues impacting payment. Claims Billing: ensure accuracy and timeliness of medical and dental billing; capture correct charges; perform HMS billing portal tasks and related file maintenance. Denials, Appeals, and Collections: audit EOBs, process appeals, maintain an insurance follow-up log, and follow up with plans to collect on denied or partially paid claims; document denials in HMS and escalate as needed. Credentialing and Enrollment: manage provider credentialing/enrollment; monitor NPI, DEA, Medicaid enrollment renewals, and related documentation. Write-Offs and Collections: write-off balances >120 days; apply waivers per policy with proper approvals. Ryan White Program Billing: assist with Ryan White Part A dental invoicing and Medicaid billing; monitor dental encounters in PE and HMS; prepare monthly invoices for Ryan White services. Clinic Training and Support: provide billing training to clinic staff; offer FMMIS training; assist with coding and encounter input at clinics. Other duties as assigned. Minimum Qualifications
Willing to work before, during, and/or beyond normal hours in emergencies. Current Florida Department of Health employee (OPS, Career Service, SES or SMS). Data entry experience. Experience evaluating medical/dental insurance eligibility. At least 1 year of customer service experience in a clerical or cashier role within the past 3 years. Preferred Qualifications
At least 2 years of health insurance claims processing within the past 3 years. Associate degree or higher from an accredited college or university. Current CPC certification. Additional Information
This position requires on-site work in Broward County. Applicants must apply via People First; no faxed or mailed applications. Applicants to provide verifiable information through the electronic application. Qualifying questions must be supported by documentation in the application. A security background check and/or drug screening, E-Verify, and direct deposit participation are required. The State of Florida is an Equal Opportunity Employer. Equal Opportunity and Veterans’ Preference
Veterans’ Preference applies per Florida statutes; documentation must be provided with submission as required.
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