Patient Refunds Specialist

NAVISTA

1d•$16 - $25

About The Position

Coordinator, Revenue Cycle Management, Patient Accounts Receivable About Navista We believe in the power of community oncology to support patients through their cancer journeys. As an oncology practice alliance comprised of more than 100 providers across 50 sites, Navista provides the support community practices need to fuel their growth—while maintaining their independence. What Revenue Cycle Management (RCM) contributes to Cardinal Health Practice Operations Management oversees the business and administrative operations of a medical practice. Revenue Cycle Management manages a team focused on a series of clinical and administrative processes that healthcare providers utilize to capture, bill, and collect patient service revenue. The revenue cycle shadows the entire patient care journey and begins with patient appointment scheduling and ends when the patient’s account balance is zero. Job Purpose: The Coordinator, Revenue Cycle Management, Patient AR analyzes data to determine whether a refund is warranted, based on contractual agreements and payments received, and administers refunds accordingly. The Credit/Refund Specialist will be responsible for the expedient and accurate refund processing of patient and insurance over payments. Essential Functions:

Requirements

2 or more years’ experience working with medical refunds preferred.
High School Diploma or equivalent degree preferred.
Associate’s degree preferred.
Previous healthcare billing and/or payment posting experience required.
Basic computer knowledge (Windows, MS Word, MS Excel, Internet).
Understanding of Electronic Response Admittances (ERAs) and Explanation of Benefits (EOBs) preferred.
Strong Attention to detail.
Ability to interact effectively and professionally with individuals at all levels; both internal and external.
Must be able to work as part of a team.
Knowledge of medical terminology preferred.
Knowledge of health insurance preferred.
Familiarity with Chemotherapy and Radiation Billing preferred.

Responsibilities

Review EOBs and ensure allowances, adjustments, unallocated payments, and overpayments are posted correctly.
Review refund requests submitted by the billing team for accuracy, before sending to the accounting department for processing.
Review and resolve accounts with credit balances/request refunds and/or adjustments as necessary.
Generate reports to identify outstanding credit balances and prepare overpayment packages as necessary.
Initiate and work up refund requests for overpayments.
Process refunds and credit balances to patients or payers.
Identify account problems, patterns, and trends.
Assist with additional payment-related functions as necessary.
Assist and respond to reports in a professional manner.
Comply with state/federal regulations and adhere to HIPAA and PHI guidelines.
Identify patient accounts with credit balances to determine whether or not a refund is due to the patient and/or insurance company.
Communicate refund status with patients/insurance companies.
Maintains refund tracking spreadsheet for all refund requests.
Follow up on requests submitted to ensure payment has been received.
Post adjustment and or payment corrections to patient accounts in billing software.
Perform other duties as assigned to meet business needs.