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Refund Processing Specialist

2 months ago

Middle River, United States Johns Hopkins University Full time

We are looking for a Credit Specialist to manage the processing of refunds and the resolution of credit balances. This role involves analyzing the EPIC billing system to ensure the accuracy of payment postings and third-party reimbursements. The Credit Specialist will conduct thorough investigations into credits and process them according to established accounting practices and procedures. This position requires interaction with various stakeholders, including physicians, administrative staff, clinical teams, accounting, and PBS personnel to address credit balance concerns while maintaining strict confidentiality of patient information, including charges, treatment plans, and diagnoses.

Key Responsibilities

Procedural Knowledge

  • Manage the processing of refunds and resolution of credit balances.
  • Prepare check requests using EPIC and SAP systems for the accounts payable department.
  • Communicate effectively with individuals outside the assigned department or institution.
  • Research and respond to inquiries regarding refunds.
  • Reconcile refunds and wire transfers with the EPIC billing system and university revenue accounts.
  • Collaborate closely with the Reconciliation and Payments team when credit balance issues arise.
  • Maintain accurate online Refund Distribution Sheets.
  • Assist with payment posting and month-end closing activities.
  • Ensure that all governmental refunds are processed within the required timeframe.
  • Verify the accuracy of refund checks and post refund debits to the EPIC system.
  • Investigate and resolve 'Suspense Postings' by contacting third-party payers and other entities.

Technical Knowledge

  • In-depth knowledge of HIPAA regulations concerning the handling of patient Protected Health Information (PHI).
  • Exercise discretion and sound judgment in resolving credit balance issues.
  • Provide management with feedback regarding any problems encountered.
  • Familiarity with JHU/PBS Billing Applications.
  • Professional Development:
  • Engage in ongoing educational activities.
  • Assist in training new staff members.
  • Stay updated on industry changes through relevant literature.
  • Complete required training sessions annually.

Department-Specific Responsibilities

Service Excellence

  • Adhere to established Service Excellence Standards.
  • Maintain positive customer relations.
  • Demonstrate effective self-management.
  • Foster teamwork and collaboration.
  • Communicate clearly and effectively.
  • Take ownership and accountability for responsibilities.
  • Commit to continuous performance improvement.

Minimum Skills & Abilities

  • Strong organizational skills, effective interpersonal abilities, and analytical skills are essential.
  • Proficient in operating basic office equipment, including copiers, fax machines, scanners, and PCs.
  • Physical Requirements:
  • Ability to sit for extended periods.
  • Capability to reach in various directions.
  • Finger dexterity for tasks such as typing.
  • Effective verbal and written communication skills.
  • Ability to see and hear within normal ranges.
  • Mobility to move around the workspace.
  • Ability to lift a minimum weight of 10 lbs.

Minimum Qualifications

  • High School diploma or GED required.
  • One year of experience in medical billing or a related medical specialty is required.
  • Additional education may substitute for required experience as permitted by the JHU equivalency formula.

Preferred Qualifications

  • One year of experience in payment posting or refund/credit balance management is preferred.
  • Familiarity with professional fee billing is advantageous.
  • Strong written and verbal communication skills are preferred.
  • Knowledge of the EPIC billing system and proficiency in PC applications are preferred.