Insurance Refund Analyst

2 weeks ago

Columbia, Missouri, United States Columbia Orthopaedic Group Full time

Job Overview:
The Patient Refund Coordinator is tasked with overseeing and executing the refund processes for both patients and insurance entities with precision and efficiency. This position requires collaboration with patients, insurance providers, and various internal teams to ensure that refund requests are resolved promptly. The Patient Refund Coordinator is vital in upholding financial integrity and nurturing positive interactions with both patients and insurers.

Primary Duties:

Refund Management:

  • Evaluate and manage patient and insurance refund requests in line with organizational policies and protocols.
  • Confirm accurate calculations and validation of refund amounts.
  • Maintain and update refund documentation within the practice management system.

Communication with Patients and Insurers:

  • Address patient inquiries regarding refunds, delivering clear and prompt responses.
  • Liaise with insurance companies to resolve refund-related issues and secure necessary approvals.
  • Tackle and rectify discrepancies or challenges associated with refund processing.

Record Keeping and Compliance:

  • Keep comprehensive records of all refund transactions and communications.
  • Ensure adherence to legal, regulatory, and internal policy standards.
  • Conduct regular audits of refund transactions to guarantee accuracy and compliance with policies.

Team Collaboration:

  • Partner with the billing department to reconcile accounts and address billing inconsistencies.
  • Work alongside the finance team to monitor and report on refund metrics and trends.
  • Contribute to the development and enhancement of refund processing procedures to improve efficiency.

Issue Resolution:

  • Investigate and resolve complex refund matters or disputes, escalating to management when necessary.
  • Identify opportunities for process improvements and propose solutions to optimize the refund workflow.

Qualifications:

  • Education: High School Diploma or equivalent required; Associate's degree in Finance, Accounting, or a related discipline preferred.
  • Experience: A minimum of [23] years in a financial or administrative capacity, with specific experience in refund management preferred.
  • Skills:
  • Strong analytical and numerical abilities.
  • Exceptional attention to detail and accuracy.
  • Proficient in financial software and Google Suite (Sheets, Docs).
  • Excellent communication and interpersonal skills.
  • Ability to manage sensitive information with discretion.

Work Environment:

  • Office setting with standard business hours. Potential for hybrid work after a designated period.
  • Occasional overtime may be necessary to meet deadlines or address urgent matters.

Physical Demands:

  • Capability to sit for extended periods and utilize a computer.

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