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AR Refund Specialist
2 months ago
Overview
WE ARE HIRINGLocation:300 E. Market St., Louisville, KY 40202
About Us
UofL Physicians is one of the largest, multi-specialty physician practices in the Kentuckiana region. With over 700 providers, 200 practice locations and 78 specialties, UofL Physicians’ academic and community physicians care for all ages and stages of life, from pediatrics to geriatrics with compassion and expertise. UofL Physicians academic providers are professors and researchers at the UofL School of Medicine, teaching tomorrow’s physicians, leading research in medical advancements and bringing the most progressive, state-of-the-art health care to every patient.
With more than 13,000 team members – physicians, surgeons, nurses, pharmacists and other highly-skilled health care professionals, UofL Health is focused on one mission: to transform the health of communities we serve through compassionate, innovative, patient-centered care.
Our MissionAs an academic health care system, we will transform the health of the communities we serve through compassionate, innovative, patient-centered care.
Job Summary:
Responsible for receiving and analyzing each account on the credit balance report(s).
Process refund requests from insurance groups and patients.
Prepare and submit Medicare Credit Balance detail report and Certification page on a quarterly basis as required by the authority of sections 1815(a), 1833(e), 1886(a)(1)(C) and related provisions of the Social Security Act.
Ensure patient balance is accurately stated after processing refund/adjustments on accounts with a credit balance.
Responsibilities
Determine whether applied payments should be refunded by researching the payment, contractual, patient liability amounts.
Gather information necessary, i.e. explanation of benefits to process refunds to the patient/guarantor.
Review explanation of benefits to confirm how payments were applied to patient accounts.
Analyze adjustments and submit necessary adjustments to be applied to the patient account.
Complete refund requests on each credit and submit to leadership for approval.
Maintain documentation for all communications, adjustments and refunds for retrieval and tracking purposes.
Keep informed of all policies and procedures related to the refunds and audit processes and ensure adherence to all federal, state, and local regulatory billing guidelines as well as payer specific billing guidelines.
Balance and log refunds processed daily.
Monitors reasons adjustments/contractuals are creating credit balances and forwards any repetitive issues to leaderships attention. Determine “root causes” of erroneous credit balances.
Ensure all account balances are correct prior to issuing refunds.
Process refunds requested by patient within five (5) working days of receipt/request.
Demonstrate the ability to work independently with minimum supervision.
Complete tasks by deadline.
Attend seminars as requested.
Other duties as assigned.
Qualifications
MINIMUM EDUCATION & EXPERIENCE
High School Diploma, or GED
Two years of experience in AR Operations, accounting, or equivalent experience preferred
KNOWLEDGE, SKILLS, & ABILITIES
Ability to analyze and interpret information on electronic remittances (ERA)/ Explanation of Benefits (EOB)
Knowledge of insurance contracts
Ability to meet productivity expectations
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