Refund Representative

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

Job Summary

Position is responsible for analyzing overpayments to patient accounts, researching account payment history and determining the appropriate refund or correction transaction.Job Description

Minimum Qualifications

Education: High School Diploma or GED

Licenses/Certifications: (None)

Experience / Knowledge / Skills:

• Two (2) years of hospital business office or medical related experience preferred
• Some knowledge of Medicare/Medicaid/Managed Care reimbursement procedures in a healthcare setting preferred but not required
• Proficient in Microsoft Office with emphasis on Excel, 10-key and math skills
• Multi-tasking in a fast paced, high volume environment

• Reviews patient account credit balance to determine required transaction. Makes the appropriate refund, adjustment, or correction entry as necessary.
• Ensures the proper insurance rules and policies are applied in performing calculations for refund transactions.
• Verifies status of multiple patient accounts and determines if refund is to be applied to other accounts.
• Assists insurance companies in the coordination of benefits to resolve account discrepancies.
• Responds to inquiries from patients, patient representatives, and/or insurance companies regarding the refund status of patient accounts.
• Prepares refund invoices required for processing overpayments. Maintains refund status records for designated accounts in order to ensure compliance with government regulations.
• Maintain all productivity goals assigned by management.
• Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff.
• Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann's service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
• Other duties as assigned.