Job Summary
This position is responsible for identifying, addressing and quality auditing all aspects of overpayments and needed refunds.
Major Responsibilities/Activities
- Identify when a refund is required
- Prepare a “packet” containing the essential paperwork to initiate a required refund
- Monitor workflows to ensure the team’s established turnaround time goal is achieved or exceeded
- Maintain client-specific processes to achieve highest client satisfaction
- Coordinate with internal teams in the processing of recoupments and payment transfers
- Review internal company documents and make suggestions of required updates
- Create new and update existing job aids and sops when needed for the Refund Department
- Quality audit team members refund paperwork to ensure the refund is compliant and the obligatory documents have been included
- Provide feedback, coaching and training to business partners which perform tasks related to refunds
- Act as the liaison between the client, business partner and internal
- Answer phone calls quickly and in a pleasant, professional manner
- Professional written and oral communication to all clients, business partners and internal customers
- Consistently support and demonstrate the company mission and values
Other Responsibilities/Activities
- Deliver refund documents by email or the secured file transfer protocol ensuring PHI and financial documents are delivered to the correct recipient
- Provide administrative support as directed
- Research and respond to inquiries in a timely manner
- Perform other necessary tasks as assigned by manager
- Follow all HIPAA compliance guidelines
Required Education, Skills, & Experience
- High School Diploma
- Intermediate Excel skills with the ability to manipulate data
- Ability to collaborate effectively with multi-departmental and diverse teams
- Strong, accurate typing and data entry skills
- Highly organized with ability to be proactive, manage time, and prioritize work with little supervision
- Willing and able to adapt to changes in work environment, procedures, priorities, schedule, and job duties
Preferred Education, Skills, & Experience
- Knowledge of HIPAA requirements and regulations
- Previous medical billing experience
- Understanding of Medicare, Medicaid, commercial, liability and patient reimbursement/billing
- Solid understanding of insurance and liability payment methods and regulations
Working Environment/Physical Requirements
- General office environment
- Typing, sitting, standing, walking, some light lifting
- Use of basic office equipment such as computer, fax, printer, copier, telephone, scanner
- Infrequently required to work extended hours without advanced notice due to business needs
