Refund Specialist

Refund Specialist

Cayuga Health and its affiliates are the region's leading healthcare system and most trusted providers of integrated health services, empowering our people in our mission to equitably improve the well-being of the communities we serve. Our commitment to providing extraordinary healthcare begins with our team of extraordinary professionals who are continuously discovering clinical innovations and enhancing access to the most up-to-date facilities, equipment, technologies, and research protocols. Cayuga Health's commitment to our employees includes competitive compensation, comprehensive employee benefits programs, and the opportunity to explore and build a career in healthcare through our many professional development programs.

This position is responsible for researching patient and insurance credit balances in an efficient, accurate and timely manner. Must have in depth knowledge and understanding of (EOBS) explanation of benefits, understanding of patient accounting, experience working in a practice management system, attention to detail, accurate typing skills, excellent interpersonal skills, communication skills, basic math and spreadsheet skills, such as Microsoft Excel

Roles and Responsibilities:

• Review credit balances on accounts to determine source and validity of overpayment.
• Research claim payment and adjustment history to validate refund requests.
• Work credit balance worklist daily ensuring timely acknowledgement of refund requests.
• Thoroughly investigate all payments and adjustments posted to accounts to validate receipt of revenue and accuracy.
• Collect and record all source documents reviewed to validate approved refund or recoupment requests along with comprehensive account notation.
• Thoroughly review claim processing history and work with claims department to respond to recoupment requests.
• Work directly with insurance companies to settle validated recoupment requests in the most effective manner.
• Follow-up to ensure approved refunds are processed.
• Assist in handling payer and patient questions and concerns.
• Be flexible in assuming other appropriate responsibilities not noted above.

Required Skills and Experience:

• Education - High School Diploma.
• Experience - 1-3 years of investigating and processing refunds in a healthcare setting
• In depth understanding of EOBS is required
• In depth understanding of insurance recoupments required

Preferred Skills and Experience:

• Experience working with Meditech - Preferred
• Licensure - CPB or CMRS certification - Preferred

Physical Requirements:

• Lifting up to 50 pounds, standing or sitting for extended periods of time, as well as repetitive use of hands and fingers.

Location and Travel Requirements:

• Onsite at CMC Main Campus

Location and Travel Requirements:

• $20.00 to $26.00 per hour

Cayuga Health System and its affiliates are committed to treating all patients, providers, staff and volunteers equitably and with dignity, ensuring the highest levels of safety, care and respect, and striving to recognize and overcome biases and policies that contribute to disparities in healthcare access, equitable care and positive health outcomes for all.

We are proud to be an Equal Employment Opportunity employer, supporting the growth and health of our employees and community by embracing the rich diversity, needs and circumstances of all peoples and prioritizing opportunities to build a diverse and inclusive workplace. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable protected characteristics.

If you require reasonable accommodation to complete a job application, pre-employment testing, a job interview or to otherwise participate in the hiring process, please contact the Cayuga Health Talent Acquisition team at .

---