REMOTE OPPORTUNITIES AVAILABLE!

ESSENTIAL JOB DUTIES:

• Processes refunds to patient accounts, maintaining appropriate knowledge and understanding of all Managed Care Contracts and Federal payors. Work overpayments request for refund letters, faxes and telephone requests.
• Utilizes computer systems and databases.
• Prepares daily Credit Balance reports. Analyzes issues causing credit balances. Corrects contractual adjustment amount if needed. Compiles refund request with appropriate documentation.
• Performs the quarterly Medicare Credit Balance review and Escheat Report. Pulls EOB's and required documentation to accurately prepare refunds for processing.
• Ensures compliance procedure for prompt recording of all refunds.
• Coordinates any refund issues with Reimbursement Manager/Supervisor and Reimbursement Specialists as needed.
• Sets priorities to meet departmental needs.
• Completes productivity reports weekly, monthly as required timely.
• Balance and clear the withholding GL’s for all SSC supported hospitals.
• Clear the Insurance Unapplied accounts for 8 hospitals.
• Facilitate and organize all audits and projects.
• Answer questions via e-mail from the Facilities, TSSC Customer Service and PASI regarding credits, refunds, offsets, GL’s and account discrepancies. These are not limited to my 4 assigned Facilities.
• Review all offsets submitted by the Collectors for all 12 hospitals to determine if the money is in the Withholding or needs to be posted by the posting staff.
• Review all negative/offset remits from the Correspondence for all 12 hospitals for the posting staff.
• Answer any training/refund questions presented by my 3 trainees and 2 seasoned Refund Representatives.
• Write step actions for various refund procedures, adjustment sheet and payment transfer procedures.
• Process all Patient Balance Transfer forms for all hospitals.
• Takes sense of ownership regarding other related duties as assigned.

EDUCATION, SKILLS & EXPERIENCE:

Education:

• High School graduate or equivalent

Experience:

• One (1) year accounts receivable experience in hospital or medical setting.
• One (1) year experience working with Managed Care Contracts preferred and Federal programs.