Accounts Receivable Refund Representative
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- 250000VZ Requisition #
Passionate, driven people dedicated to making a difference in healthcare.
SpecialtyCare continues to grow and we’d like you to grow with us. We are seeking an Accounts Receivable Refund Representative.
Focused on Excellence: At SpecialtyCare, everyone makes a difference in the delivery of healthcare. Each of us, no matter the role, is important to the success of our company, the success of our customers, and the health of our patients. Exceptional care and positive patient outcomes require team members passionately dedicated to collaborating and driving excellence at every turn–from clinicians in the operating room to administrative people providing support behind the scenes. Highly successful companies need top talent in every position. And, with our outstanding work environment and our focus on people as one of our critical success factors, we are very committed to you, your career, and your success.
PURPOSE OF THE POSITION: Identify and process patient and provider overpayments and credit balances to patient and insurance companies.
ESSENTIAL JOB FUNCTIONS
- Research and resolve overpayment requests and credit balances
- Identify billing errors to be corrected by coding team.
- Research insurance medical policies and guidelines.
- Respond to payer correspondence in a timely manner.
- Communicate payment or denial trends to management in a timely manner.
- Document all follow up efforts and communication within practice management system.
- Develop and maintain positive working relationship with team members
- Live the SpecialtyCare Values – Integrity, Teamwork, Care & Improvement.
- Perform other duties as assigned.
BASIC QUALIFICATIONS:
- Education:
- One (1) year certificate from a college or technical school.
- Experience:
- Three (3) years related experience and/or training
- Equivalent combination of education and experience, acceptable.
- Knowledge and Skills:
- Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume
- Good understanding of debits and credits and the billing process.
- Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
- Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form.
- Proficient with a computer and good knowledge and understanding of MS office programs, and email. Experience working with PeopleSoft and JD Edwards helpful.
- Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
- Ability to write reports, business correspondence, and procedure manuals.
- Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
- While performing the essential duties of this job, the associate is required to stand, walk, sit, use hands to grasp, handle or feel objects, tools or controls, reach with hands and arms, stoop, kneel, crouch, talk or hear. Hearing must be normal with or without correction.
- Must be able to lift and/or move, push or pull 25 pounds or more.
- Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus. Vision must be normal with or without correction.
- Associates work in a business office setting.
- Typical noise level is moderate.
- Ability to work a minimum of eight (8) hours per day and longer if needed according to workload.
- Ability to work in a demanding, fast paced environment.
The Successful Candidate: The successful candidate must bring a high level of ethical, intellectual, professional and personal values that complement the team and company vision.
The following competencies are highly valued:
Has high attention to detail with the ability to analyze information.
High energy, self-motivated individual whose style is effective in working with all levels of the organization to drive performance and continuous improvement using an analytical and metrics based approach.
Lives the SpecialtyCare Values – Integrity, Care, Urgency, and Improvement.
SpecialtyCare is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.