Refund Specialist

Job Description

Responsibilities

Independence Physician Management (IPM) , is a subsidiary of Universal Health Services, Inc (UHS). IPM was formed in 2 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve.

Position Overview:
The responsible for the accurate and timely resolution of the Practice Management System (PMS) self-pay and insurance credits.

Duties and Responsibilities:

Thoroughly researches credit balances to determine if an overpayment occurred and initiates the refund process accordingly outlining the reason for the refund and including explanation of benefits (EOBs), if needed. Handles payer refund requests including validating the refund following review of the account history and submission of a refund request to Accounts Payable. Meets or exceeds established performance targets (productivity and quality) established by their supervisor. Partners with the Reimbursement Specialists, as needed, to research accounts and validate self-pay and insurance refunds. Maintains a working knowledge of CPT-4 and ICD- coding principles, government, managed care and commercial payers, payment posting, ERA processing, claim adjustment reason codes, contractual adjustment, copays, coinsurance, and deductibles. Demonstrates the ability to be an effective collaborator. Upholds “best practices” in day-to-day processes and workflow standardization to drive maximum efficiency across the team.
Qualifications

High School Graduate/GED required. Technical school or associate degree preferred. Experience (3-5 years minimum) working in a healthcare (professional) billing, health insurance or equivalent operations work environment. Healthcare (professional) billing, knowledge of CPT/ICD- coding, claim submission requirements, payment posting and remittance processing. Understanding of the revenue cycle and how the various components work together preferred. Excellent organization skills, diligence, research and problem-solving ability. Results oriented with a proven history of accomplishing tasks within a high-performing team environment. Service-oriented/customer-centric. Strong computer literacy skills including proficiency in Microsoft Office. Billing software (e.g., Cerner, Epic, IDX) experience highly desirable.

As an IPM employee you will be part of a first-class organization offering:
Benefits Highlights:
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• (K) with company match and discounted stock plan
• Tuition Reimbursement
and much more

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