Lead Refund Processing Specialist
2 weeks ago
As a Senior Refund Operations Analyst, you will play a crucial role in enhancing the efficiency of our refund processes. Your expertise will guide the team in resolving complex issues and ensuring a seamless workflow.
Key Responsibilities:
- Facilitate the training and development of both new and existing refund analysts.
- Provide technical support to the management team and assist in resolving queries from team members.
- Manage the processing of system credits related to refunds and returned checks for various groups.
- Deliver exceptional customer service regarding refund inquiries for both internal and external stakeholders.
- Draft and dispatch refund request letters in accordance with established guidelines, ensuring timely follow-ups.
- Engage with remote groups to address check and void discrepancies, and undertake projects as necessary.
- Support team members in navigating complex system adjustments and customer service challenges.
- Oversee and coordinate daily operations among team members to maintain productivity.
- Offer guidance to refund analysts across all plan types and business lines.
- Participate in special projects requiring proficiency in Excel and Word.
- Assume auditing responsibilities for new hires until performance objectives are achieved.
- Foster a collaborative team environment that encourages productivity and engagement.
Position Qualifications:
- A minimum of 5 years of experience in claims processing.
- Demonstrated leadership capabilities.
- Familiarity with the claim payment and adjustment systems used by AmeriHealth Administrators.
- Ability to inspire and delegate tasks effectively.
- Strong problem-solving aptitude.
- Exceptional organizational skills with a keen attention to detail.
- Excellent written and verbal communication abilities.
- Knowledge of ICD-9, CPT-4, and HCPCS coding.
- A college degree or equivalent experience is preferred.
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