RCM Refund Specialist

ALLERGY PARTNERS•Asheville, NC

3d•Onsite

About The Position

This role is responsible for processing patient and insurance refunds. Key duties include reviewing credits, researching patient accounts, determining the validity of credits by verifying payment methods and pulling remits, adjusting small balances, conveying monies, issuing patient credits via refund checks, preparing detailed reports for management review and signature, running financial reports for accounting, preparing and mailing checks, and filing corresponding copies. The role also involves processing returned refunds, attempting to contact patients to re-send refunds, maintaining patient confidentiality and HIPAA compliance, staying knowledgeable about practice management software, attending required training (OSHA, HIPAA, OIG, AP training), attending meetings, and performing additional duties as requested by management. The position requires adherence to company policies and reporting any violations.

Requirements

High school diploma or GED equivalent.
Healthcare or related experience required.
One to three years of experience, preferably in a healthcare billing setting.
Good communication skills, both written and oral.
Proficient computer skills including word processing, and data entry.
Must have ability to communicate professionally and effectively with management and co-workers.
Detail oriented with the ability to detect errors and discrepancies.
Ability to work independently and stay focused on task at hand.
Good eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment.
Normal range of hearing and vision must be correctable to normal range to record, prepare, and communicate appropriate reports.

Responsibilities

Processing of patient and insurance refunds.
Review credits and research patient accounts for both Patient and Insurance.
Determine if there is a true credit for patient or Insurance by verifying payment method and pulling remits.
Adjust small balances and convey monies.
Issue patient credits by writing Refund checks.
Prepare the refund checks with detailed reports for Management to review and obtain signature.
Run financial reports for accounting to review.
Prepare and mail checks.
File corresponding copies as backup.
Process Returned refunds with accounting department.
Attempt contact with patient to re-send refund.
Maintains patient confidentiality; complies with HIPAA and compliance guidelines established by the practice.
Maintains detailed knowledge of practice management and other computer software as it relates to job functions.
Attends OSHA, HIPAA, and OIG training programs as required.
Attends all meetings as requested including regular staff meetings.
Performs any additional duties as requested by the Director of Central Billing Services and/or Manager or Team Leader/ Supervisor.
Completes all assigned AP training (such as CPR, OSHA, HIPAA, Compliance, Information Security, others) within designated timeframes.
Complies with Allergy Partners and respective hub/department policies and reports incidents of policy violations to a Supervisor/Manager/Director, Department of Compliance & Privacy or via the AP EthicsPoint hotline.