Refund Specialist

Millennium Health•San Diego, CA

5d•$18 - $21

About The Position

Millennium Health LLC is an accredited specialty laboratory with more than a decade of experience in medication monitoring and drug testing services, helping clinicians monitor the use and misuse of prescription medications and illicit drugs. The testing is used by healthcare professionals to obtain objective information about patients’ recent use of prescription medications and/or illicit drugs and helps monitor the effectiveness of treatment plans. The Refund Specialist is responsible for processing and researching credit balances and processing refunds.

Requirements

High School Diploma or GED
Minimum two years of posting medical insurance payments experience
Ability to read and understand the different types of health insurance EOBs
Communicate and work effectively in a team environment
Ability to read, understand, and follow oral and written instructions
Knowledge of computer programs and business office procedures
Ability to operate a computer, 10-key by touch, and basic office equipment
Must be well-organized and detail-oriented
Ability to meet deadlines and goals in a high-volume, fast-paced environment is required
Knowledge of cash accounting and accounts receivable process
Flexibility to work overtime

Responsibilities

Requires the overall knowledge, skills, and abilities to perform any functional role within Cash Management/Refunds.
Ability to research/identify issues and problems, develop solutions, and prepare recommendations, including policies and procedures.
Reviews, validates, and processes customer or insurance overpayment refunds, ensuring accuracy, compliance, and timely resolution. Including interacting with insurance companies via phone, verifying eligibility, and claim status.
Communicates with supervisor or lead for approvals and actions needed to resolve outstanding refund requests.
Responsible for researching and resolving the following exception report: Provider Level Adjustment( PLB) by following the departmental policies and procedures.
Reconcile Credit Balance Report accounts.
Recommends operational changes to improve the efficiency of the department.
Notifies Supervisor/lead on recurring issues and substantial dollars related to adjustments and/or refunds, and issues that impact production and quality.
Participates in educational activities and attends monthly staff meetings.
Ability to ensure HIPAA, confidentiality, and compliance policies, procedures, and standards are always adhered to.
Ability to ensure administrative, physical, and technical cybersecurity controls are always adhered to.