REFUND SPECIALIST
US-WA-Wenatchee
External
Req #: 14897
Type: Full-Time
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Overview: To process accurate and timely refunds to insurance carriers and patients. Position Report To: Business Office Manager Responsibilities: * Works assigned Work queues in the Revenue Cycle system on a daily basis. * Processes refunds to insurance companies and patients timely and accurately. * Accurately codes insurance information on coverage records in Revenue Cycle system within 24 hours of receipt. When necessary, verifies information via various electronic means. * Via work queues and receipt of correspondence from insurance carriers, provides follow-up of overpaid (or incorrectly paid) claims as dictated by department policy. Submits corrected claims as needed and processes appeals for incorrect refund requests. (Processes write-offs as needed and as dictated by department policy.). * When available, processes on-line adjustments to insurance claims. * Complies with audit requests by insurance carriers in a timely fashion. * Accurately processes corrections on accounts and/or active claims by error correcting or voiding transactions as indicated in department policy. Posts appropriate adjustments as needed. * Appropriately documents all patient accounts with each action taken and each contact made. * Thoroughly researches credit balances and processes insurance refunds or adjustments as needed. * Thoroughly researches credit balances and processes patient refunds or adjustments as needed. * Responsible to keep up-to-date with current insurance refund requirements and changes by reading payer newsletters, reviewing websites and other publications. * Participates in payer meetings, developing relations with payer representatives and assisting with troubleshooting and problem-solving processes. * Actively participates in departmental and/or organizational process improvement initiatives. * Assists in other areas of the department (i.e., payments or coding) as needed. * Assists providers and staff in other departments with insurance and billing inquiries in a friendly and professional manner while on the phone or corresponding though email. * Assists in maintaining a neat and professional workplace. * Works on special projects related to A/R clean up as requested by Manager. * Performs other tasks as requested by Supervisor, Manager or Director. * Performs other duties as assigned. Demonstrate standards of behavior and adhere to the Code of Conduct in all aspects of job performance at all times. Qualifications: Required: * High School Diploma or equivalent. * Proficient in the performance of basic math functions. Possesses basic computer (e.g., spreadsheets, word processing) skills. * Must be a team player. * Maintain a positive, resourceful attitude toward achieving overall department and clinic goals. Desired: * Post-Secondary courses. * 2 years Revenue Cycle experience or AAHAM, HFMA, or AAPC Certification.
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