Analyzes all credit balances before a refund or adjudication is considered and/or processed. Analyzes accounts for posting errors and may assist with the Medicaid/Medicare Quarterly Credit Balance Reports to include all entities. Performs duties while remaining compliant to all CMS and Cape Fear Valley Health Compliance guidelines. May assist with the preparation of the annual Escheatment Report to ensure all North Carolina Escheatment processes are followed. Major Job Functions The following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below. In addition, specific functions may change from time to time: Identifies and reviews accounts for proper resolution by balance transfer, adjustment or refund to the proper entity Determines if a refund is needed and follows correct procedure for completing refund request and any necessary paperwork for the Accounts Payable Department Calls insurance companies regarding any discrepancy in payments or coordination of benefits if necessary Calls patient regarding any discrepancy in coordination of benefits if necessary Follows proper procedure for forwarding accounts to other departments for resolution if needed Reviews incoming refund requests for accuracy and processes refunds Other duties as assigned
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Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED