Overpayment Recovery Specialist

3 days ago


San Antonio, Texas, United States South Texas Radiology Group Full time
Job Title:

Overpayment Recovery Specialist

Job Summary:

The Overpayment Recovery Specialist plays a crucial role in managing overpayment requests and recoupment processes within the Radiology billing department. This position requires a high level of attention to detail, organizational skills, and effective communication with various departments to address and resolve overpayment issues efficiently.

Key Responsibilities:
  • Process overpayment requests through specific insurance company portals.
  • Ensure timely and accurate handling of overpayment claims.
  • Monitor and track overpayment cases to ensure proper documentation and resolution.
  • Review and verify documentation for overpayment claims, ensuring completeness and accuracy.
  • Prepare and provide supporting documents, such as medical reports and coordination of benefits.
  • Maintain organized records of overpayment transactions and communications.
  • Respond to overpayment requests and related inquiries promptly.
  • Ensure timely provision of necessary information to facilitate claim resolution.
  • Apply knowledge of bundling, MPPR adjustments, and multiple surgical adjustments.
  • Review recoupments automatically offset from payments by insurance companies to ensure no prior documentation is missing.
  • Determine the appropriate department for processing each recoupment case.
  • Verify that adjustments are posted correctly according to the appropriate fee schedules within our Billing System.
  • Ensure compliance with current fee schedule guidelines.
  • Coordinate with internal departments to manage and resolve overpayment and recoupment issues.
  • Communicate effectively with insurance companies to resolve discrepancies and obtain necessary information.
  • Identify opportunities for process improvements to enhance the efficiency and accuracy of overpayment management.
  • Provide input on improving policies and procedures related to overpayment and recoupment handling.
  • Generate reports on overpayment and recoupment activities, summarizing key metrics and trends.
  • Report on the status of overpayment resolutions and any issues encountered during the process.
  • Make outbound calls to patients to resolve requests or issues.
  • Assist as a backup for Cashier as needed.
  • Meet departmental quality and production standards.
  • Contribute to a positive team culture.
Requirements:
  • Exceptional written and verbal communication skills.
  • Organizational skills, able to prioritize.
  • Minimum of 6 months of experience in medical billing, specifically in handling overpayments and recoupments.
  • Computer skills to include Google Suite or similar software.
  • Type at least 30 wpm and proficient in 10-key by touch.
  • Ability to read and understand explanation of benefits (EOBs).
  • Provide quality customer service - problem solving and decision making.
  • Must be able to multitask and be a team player.
  • Maintain confidentiality at all times.
Education:

High School Diploma or GED. Associates degree preferred.

Attendance/Work Schedule:

Maintaining and satisfying minimum attendance requirements is an essential function of this position, including working all full-time regular hours as established for this position and scheduled or emergency overtime.



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