Refund Specialist

UHS•Tredyffrin Township, PA

1d•Hybrid

About The Position

Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve. The Refund Specialist is responsible for the accurate and timely resolution of the Practice Management System (PMS) self-pay and insurance credits. This role requires a 3-month training period in the King of Prussia, PA headquarters.

Requirements

High School Graduate/GED required.
Experience (3-5 years minimum) working in a healthcare (professional) billing, health insurance or equivalent operations work environment.
Healthcare (professional) billing, knowledge of CPT/ICD-10 coding, claim submission requirements, payment posting and remittance processing.
Excellent organization skills, diligence, research and problem-solving ability.
Results oriented with a proven history of accomplishing tasks within a high-performing team environment.
Service-oriented/customer-centric.
Strong computer literacy skills including proficiency in Microsoft Office.

Nice To Haves

Technical school or associate degree preferred.
Understanding of the revenue cycle and how the various components work together preferred.
Billing software (e.g., Cerner, Epic, IDX) experience highly desirable.

Responsibilities

Thoroughly researches credit balances to determine if an overpayment occurred and initiates the refund process accordingly outlining the reason for the refund and including explanation of benefits (EOBs), if needed.
Handles payer refund requests including validating the refund following review of the account history and submission of a refund request to Accounts Payable.
Meets or exceeds established performance targets (productivity and quality) established by their supervisor.
Partners with the Reimbursement Specialists, as needed, to research accounts and validate self-pay and insurance refunds.
Maintains a working knowledge of CPT-4 and ICD-10 coding principles, government, managed care and commercial payers, payment posting, ERA processing, claim adjustment reason codes, contractual adjustment, copays, coinsurance, and deductibles.
Demonstrates the ability to be an effective collaborator.
Upholds “best practices” in day-to-day processes and workflow standardization to drive maximum efficiency across the team.