Refund Specialist

Tennessee Orthopaedic Alliance•Nashville, TN

4d•Onsite

About The Position

Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Nashville and Middle Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state. There are a number of reasons why TOA is an employer of choice; here are a few of them: Stability - TOA has been in Middle Tennessee since 1926 and has expanded to nearly 20 locations! Impact - TOA’s team members use our careers – whether in our clinics or our business office – to make a positive difference in the community by building relationships and helping patients live their best life. Work Environment - The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement. Total Rewards - TOA offers competitive salaries based on the current Middle Tennessee wage market, plus a comprehensive suite of benefits, including Medical, Dental, Paid Time Off, and more. Our 401(k) plan provides a company match, safe harbor match and profit sharing match to go along with your contributions. The Refund Specialist is an important part of the TOA Central Business Office, our operation that focuses on revenue cycle excellence. As a Refund Specialist, you will use your analytical, financial, and customer service skills to ensure that the accounts of our TOA patients are accurate and reconciled in a timely fashion. Essentially, you’ll be working to make sure any overage that is due to a TOA patient is returned to them timely. This position reports to our Revenue Cycle Manager, and is located at our Central Business Office location. Meets quality assurance and productivity standards by identifying, reconciling credit balance accounts and reviewing credit balance reports for potential over payments.

Requirements

High school diploma or equivalent is required.
At least one year medical office – revenue cycle experience is preferred, with some experience with an orthopaedic practice a plus
Exceptional customer service and patient focus. Our Refund Specialists often speak with our patients, providers, and payors, and it is essential that they are able to make each encounter as positive as possible.
Knowledge of Insurance - particularly health insurance provisions is essential, accounts payable and accounts receivable is preferred.
Knowledge of administrative and clerical procedures, including experience with computer systems. Experience with an EHR or NextGen is a plus
An exceptional focus on attention to detail, ensuring that all documentation is entered accurately and swiftly, and that each transaction is reconciled correctly.
Collaboration, working closely with Central Business Office and clinical colleagues and administrative team mates to develop a cohesive, high performing team
An energetic and enthusiastic pace at work, with the ability to swiftly and accurately manage the flow documents through our EHR, without any diminishing focus on accuracy
Dependability, with a reliance on the capacity to be at work on-time, every day so our patients can receive the administrative support they need in a timely manner

Nice To Haves

At least one year medical office – revenue cycle experience is preferred, with some experience with an orthopaedic practice a plus
Knowledge of Insurance - particularly health insurance provisions is essential, accounts payable and accounts receivable is preferred.
Knowledge of administrative and clerical procedures, including experience with computer systems. Experience with an EHR or NextGen is a plus

Responsibilities

Ensures accuracy of refund requests by doing the appropriate research and reconciliation of credit balance accounts and analyzing patients’ accounts utilizing our Electronic Health Record (EHR) system - NextgGen to determine appropriate action.
Communicate with patients, TOA staff and insurance payers to ensure timely and accurate resolutions of account transactions. This may include the review of third party claims (i.e. MVA settlements, workers compensation claims.)
Prioritize assigned accounts to maximize aged accounts receivable resolution
Review explanation of benefit (EOB) documentation and third party claims/workman’s comp. to perform account resolution
Process, post, and prepare approved refunds through our EHR system
Operate within established guidelines and protocols, including providing backup documentation for our accounting and audit functions