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Credit and Refund Representative I

3 months ago

York, Pennsylvania, United States WellSpan Health Full time
Credit and Refund Representative I

Location:
WellSpan Health, York, PA

Schedule:
Full Time

Sign-On Bonus Eligible

Remote/Hybrid

Regular

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General Summary


Provides prompt, efficient and accurate resolution of all Hospital and Professional Billing insurance credits in accordance with established policies and procedures.

Duties and Responsibilities

Essential Functions:


Accesses credit balance work queues on a daily basis to ensure accurate and timely follow up and resolution of accounts with credit balances.

Performs various functions within the credit balance AR including but not limited to insurance refund and adjustment requests.

Investigates historical data for each account for potential refund of credit

Researches hospital transaction activity and accesses detailed remit data to determine appropriate account resolution.

Interacts with the appropriate Teams to determine proper account resolution.

Researches Medicare and Medicaid accounts for inclusion on the Medicare and Medicaid quarterly credit balance reports. Completes Medicare and Medicaid quarterly credit balance reports.

Researches payor policies and contracts applies payor guidelines for refunding overpayments, including small balance write offs.

Refunds insurance payers as necessary to resolve credits within billing system

Maintains knowledge of Legacy and Third-party systems needed to process refunds and transfer outstanding balances between such systems.

Completes payment research request for payments not posted or accounted for in Epic or legacy systems. Will post to account as needed.

Reviews and maintains personal follow-up work queues.

Special projects as assigned.

Common Expectations:
Assists with correspondence, reports, filing, scanning as needed.

Prepares and maintains records of credits and refunds.

Maintains appropriate records, reports, and files as required.

Maintains knowledge of established policies and procedures, objectives, quality assessment, safety, environmental and infection control standards.

Participates in educational programs and in-service meetings.

Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Required for All Jobs:
Performs other related duties as identified.


WellSpan Health has adopted and implemented a compliance program to support WellSpan's values and standards for professionalism, integrity, and ethics.

Expected to support and meet the values and standards of the organization and the performance expectations of the job, the department, and the compliance program.


WellSpan Health has adopted and implemented a privacy program to safeguard the patient information and the business and operational information of the organization.

Expected to support and meet the values and standards of the organization to safeguard patient and business/operational information.

The above statements are intended to describe the general nature and level of work being performed.

They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.


Physical Demands:
Standing - Occasionally

Walking - Occasionally

Sitting - Frequently

Reaching - Rarely

Talking - Frequently

Hearing - Frequently

Repetitive Motions - Occasionally

Eye/Hand/Foot Coordination - Occasionally

Qualifications

Minimum Education:
High School Diploma or GED Required

Work Experience:
Less than 1 year Related experience. Required

1 year Experience in Revenue Cycle/Healthcare Billing Preferred

Knowledge, Skills, and Abilities:
Excellent communication and interpersonal skills.

Apply Now

You're unique and you belong here.

At WellSpan Health, we are committed to treating all applicants fairly and equitably, regardless of their job classification.

If you require assistance or accommodation due to a disability, please reach out to us via email We will evaluate requests for accommodation on a case-by-case basis.

Please note that we will only respond to inquiries related to reasonable accommodation from this email address.

Rest assured, all requests for assistance or accommodation are handled confidentially, allowing applicants to share their needs openly and honestly with us.

WellSpan Health is an Equal Opportunity Employer.

It is the policy and intention of the System to maintain consistent and equal treatment toward applicants and employees of all job classifications without regard to age, sex, race, color, religion, sexual orientation, gender identity, transgender status, national origin, ancestry, veteran status, disability, or any other legally protected characteristic.