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Sr Refund Analyst
3 months ago
•Assist in training of new and existing refund analysis.
•Supports manager in providing technical assistance'•to team members.
•Process system credits on refund/returned checks for AHA, insured and remote groups.
•Provide customer service on refund issues for internal and external customers.
•Send refund request letters according to refund guidelines and follow up according to guidelines.
•Contact tor remote groups on check and void issues. Does projects for remote groups when required.
•Assists team members in resolving difficult and/or 11,::,mplicated system adjustments or customer service issues.
•Maintains and coordinates daily workflow among team members.
•Provides guidance to refund analysts in all plan types and lines of business.
•Duties will include special projects. Excel and Word knowledge required.
•Assumes audit responsibilities of new employees until established goals are met.
•Create and maintain a team atmosphere and work 1a environment to promote work productivity.
Position Qualifications:
•Minimum of 5 years' experience in claims processing.
•Proven leadership skills.
•Knowledge of AmeriHealth Administrators claim-is payment/adjustment system.
•Ability to motivate and delegate when necessary.
•Excellent problem-solving skills.
•Excellent organizational skills and detail oriented
•Excellent written and verbal communication skills
•Familiarity with ICD-9 codes, CPT-4 codes, and HCPCS codes.
•The ideal candidate will have a College Degro1,:1 or equivalent experience.
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