Credits & Refunds Specialist

1000 Wellstar Health System, Inc.•Atlanta, GA

6h•Onsite

About The Position

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Requirements

High School Graduate
Minimum 4 years healthcare related credit resolution experience
Basic knowledge of medical terminology
Basic experience and knowledge of PC applications
Detailed-oriented, good organizational skills, and ability to be self-directed
Strong time management skills, managing multiple priorities and a heavy workload in a high-stress atmosphere
Flexibility to perform other tasks as needed in an active work environment with changing work needs
High-level problem solving, analytical, and investigational skills
Excellent internal/external customer service skills
Excellent communication skills to include oral and written comprehension and expression
Ability to: Learn quickly and meet continuous timelines
Exhibit behaviors consistent with principles of excellent service
Demonstrate and maintain competency as required for job title and the unit/area(s) of assignment
Exhibit behaviors consistent with standards of performance improvement and organizational values (e.g., efficiency and financial responsibility, safety, partnership and service, teamwork, compassion, integrity, trust, and respect)

Nice To Haves

BA or BS Preferred

Responsibilities

Recommend accounts for contractual or administrative write-off, along with appropriate justification and documentation
Meet productivity standards, targets, error ratios, and reporting requirements as assigned by the department manager or supervisor
Provide individual contribution to the overall team effort fo achieving the department AR goal
Identify opportunities for system and process improvement and submit to leadership
Demonstrate knowledge of HIPAA privacy standards and ensure compliance with system PHI privacy practices
Demonstrate proficient use of systems and execution of processes in all areas of responsibilities
Follow the WellStar general Policies and Procedures, the Departments Policies and Procedures, and the Emergency Preparedness Procedures.
Follow JACHO and outside regulatory agencies mandated rules and procedures
Utilize assigned menus and pathways in the hospital mainframe system and report software application problems to the appropriate supervisor
Utilize assigned menus and pathways in foreign software applications and report software application problems to the appropriate supervisor.
Utilize assigned computer hardware and report hardware problems to the appropriate supervisor
Participate in the testing for assigned software applications, including verification of field integrity
Accurately complete special projects as assigned by leadership
Knowledge and understanding of all needed system functions
Knowledge of imaging system utilized
Knowledge of Excel and Word as required for job functions
Cross training of departmental job functions
Positive team member and communication
Perform other duties and responsibilities as assigned
Responsible for reviewing and resolving credit balances on designated accounts
Reading and understanding all Managed Care contracts and payer requirements
Administering appeals for refunds requested in error
Accurately compose account information for review and approval by supervisor
Maintain individual and department daily, weekly, and monthly Key Performance Indicator goals as established by leadership
Produce daily, weekly, and monthly productivity reports
Accurately apply/correct contractual adjustment requests
Accurately and timely resolve credit balances in assigned EPIC WQs
Knowledge of payer specific programs and websites such as CMS pricer, GAMMIS, and FISS as required for job functions
Clear and concise account document of credit resolution details
Entering clear and concise EPIC account notes
Meet productivity standards as provided by leadership
Provide supporting documentation with each refund request processed
Accurate letters and envelopes with each refund request
Accurate refund and adjustment requests
Quality Assurance accuracy rate of or greater
Performs other duties as assigned
Complies with all Wellstar Health System policies, standards of work, and code of conduct.