Refunds Specialist I
3 months ago
Support in the reconciling, correction, and/or completion of contractual adjustments, insurance refunds, patient refunds, and other department specific duties as assigned. Other duties may include, but are not limited to, assistance with retraction analysis, government overpayment reporting, log balancing, Medicare Bad Debt Maintenance, and legal support functions
Essential Duties and Responsibilities
(List in order of importance or percentage of time spent on the particular responsibility - High to Low
1.
Reconcile payments and adjustments on patient accounts to ensure proper transaction codes and amounts have been applied
2.
Identify trends in erroneous postings and report to supervisor
3.
Submit accurate corrections to erroneous postings with regards to transaction codes and transaction amounts
4.
Push accounts through the proper channels to ensure efficient flow through the revenue cycle
5.
Research credit balance accounts to determine if a payor or patient has overpaid on the account
6.
Price claims using contracts, pricers, and payment methodologies to validate refund requests from payors
7.
Pull documentation needed to support the patient or insurance refund request
8.
Accurate completion of refund request forms and all daily workload
9.
Consistently meet or exceed productivity expectations set for by leadership
10
Ability to perform all other duties as assigned or requested
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Refund Representative I
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