Hospital Refund Specialist - Dallas, United States - United Surgical Partners

Description

Role and Responsibilities:

The Hospital Refund Specialist has the responsibility of identifying and resolving credit balances on patient accounts to ensure refunds are issued in a timely manner.

This position ensures the highest quality and safe delivery of customer service, maintain compliance with professionalism and regulatory processes. Interface with facility clients and internal corporate stakeholders.
Manage daily work queues of credit balances for both onshore & offshore teams.
Research, initiate follow-up and resolve all health care insurance claim accounts with existing credit balances.
Complete thorough review of patients accounts with credit balances to validate the patient overpayment is accurate.

Recommend an adjustment when applicable or recommend a refund of the overpayments to the insurance carrier or patient, providing the appropriate documentation.

Apply knowledge related to insurance contracts, interpret explanation of benefits, understand regulations concerning coordination of benefits and other applicable guidelines.

Process refunds accurately and in timely manner adhering to contract language where appropriate.
Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution of claims.

Use critical and analytical problem-solving skills to resolve issuesUses strong organizational skills to effectively manage large amounts of detailed informationUtilizes excellent written and oral communication skills to collaborate and maintain positive working relationships with peers, leaders, surgery centers, and payer representatives to resolve credit balances.

Consistent, regular, punctual attendance as scheduled is an essential responsibility of this positionOther duties as assignedRequired SkillsRequired ExperienceQualifications and Education Requirements:
High school graduate or equivalent.

Must have the skills necessary to operate the office equipment required to fulfill job dutiesExcel, Word, OutlookAble to navigate through nThrive and Availity (preferred)Previous credit balance resolution experience in a facility or CBO environment2 years combined experience CBO in Billing, Cash Collections, Denials, Disputes, Follow-up, and/or appealsUnderstanding of medical terminologyBasic understanding of credit and refund guidelinesAdditional NotesThis is not an all-inclusive list.

Additional tasks and responsibilities may be added by management based on business need.#J-18808-Ljbffr