Senior Refunds Representative (Hybrid)
Memorial Hermann Health System, Houston, TX, United States
Job Summary
Position is responsible for analyzing overpayments to patient accounts, researching account payment history and determining the appropriate refund or corrective transaction.
Desired Skill Sets
3 - 5 years Refunds experience
Epic experience
Minimum Qualifications Education:
High School Diploma or GED, preferred
Licenses/Certifications:
(None)
Experience / Knowledge / Skills:
Three (3) to five (5) years clerical experience involving medical insurance and business office or collections procedures preferred
Thorough knowledge of Medicare/Medicaid/and Managed Care reimbursement procedures in a healthcare setting required
Proficient in Microsoft Office with emphasis on Excel, 10‑key and math skills
Multi‑tasking in a fast paced, high volume, environment
Principal Accountabilities
Reviews the work of Refund Reps, approving and forwarding as appropriate.
Reviews patient account credit balance to determine required transaction.
Makes the appropriate refund, adjustment, or correction entry as necessary.
Ensures the proper insurance rules and policies are applied in performing calculations for refund transactions.
Verifies status of multiple patient accounts and determines if refund is to be applied to other accounts.
Assists insurance companies in the coordination of benefits to resolve account discrepancies.
Responds to inquiries from patients, patient representatives, and/or insurance companies regarding the refund status of patient accounts.
Prepares refund invoices required for processing overpayments. Maintains refund status records for designated accounts in order to ensure compliance with government regulations.
Mentors and serves as a resource to less experienced staff.
Prepares written response for administrative complaints and problem accounts.
Assists with the development of refund policies and procedures.
Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
Other duties as assigned.
#J-18808-Ljbffr
Desired Skill Sets
3 - 5 years Refunds experience
Epic experience
Minimum Qualifications Education:
High School Diploma or GED, preferred
Licenses/Certifications:
(None)
Experience / Knowledge / Skills:
Three (3) to five (5) years clerical experience involving medical insurance and business office or collections procedures preferred
Thorough knowledge of Medicare/Medicaid/and Managed Care reimbursement procedures in a healthcare setting required
Proficient in Microsoft Office with emphasis on Excel, 10‑key and math skills
Multi‑tasking in a fast paced, high volume, environment
Principal Accountabilities
Reviews the work of Refund Reps, approving and forwarding as appropriate.
Reviews patient account credit balance to determine required transaction.
Makes the appropriate refund, adjustment, or correction entry as necessary.
Ensures the proper insurance rules and policies are applied in performing calculations for refund transactions.
Verifies status of multiple patient accounts and determines if refund is to be applied to other accounts.
Assists insurance companies in the coordination of benefits to resolve account discrepancies.
Responds to inquiries from patients, patient representatives, and/or insurance companies regarding the refund status of patient accounts.
Prepares refund invoices required for processing overpayments. Maintains refund status records for designated accounts in order to ensure compliance with government regulations.
Mentors and serves as a resource to less experienced staff.
Prepares written response for administrative complaints and problem accounts.
Assists with the development of refund policies and procedures.
Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
Other duties as assigned.
#J-18808-Ljbffr