Refunds Specialist

EMS Management & Consultants, Inc.


Date: 8 hours ago
City: Winston-Salem, NC
Contract type: Full time
Remote
Description

Job Summary

This position is responsible for identifying, addressing and quality auditing all aspects of overpayments and needed refunds.

Major Responsibilities/Activities

  • Identify when a refund is required
  • Prepare a “packet” containing the essential paperwork to initiate a required refund
  • Monitor workflows to ensure the team’s established turnaround time goal is achieved or exceeded
  • Maintain client-specific processes to achieve highest client satisfaction
  • Coordinate with internal teams in the processing of recoupments and payment transfers
  • Review internal company documents and make suggestions of required updates
  • Create new and update existing job aids and sops when needed for the Refund Department
  • Quality audit team members refund paperwork to ensure the refund is compliant and the obligatory documents have been included
  • Provide feedback, coaching and training to business partners which perform tasks related to refunds
  • Act as the liaison between the client, business partner and internal
  • Answer phone calls quickly and in a pleasant, professional manner
  • Professional written and oral communication to all clients, business partners and internal customers
  • Consistently support and demonstrate the company mission and values

Other Responsibilities/Activities

  • Deliver refund documents by email or the secured file transfer protocol ensuring PHI and financial documents are delivered to the correct recipient
  • Provide administrative support as directed
  • Research and respond to inquiries in a timely manner
  • Perform other necessary tasks as assigned by manager
  • Follow all HIPAA compliance guidelines

Requirements

Required Education, Skills, & Experience

  • High School Diploma
  • Intermediate Excel skills with the ability to manipulate data
  • Ability to collaborate effectively with multi-departmental and diverse teams
  • Strong, accurate typing and data entry skills
  • Highly organized with ability to be proactive, manage time, and prioritize work with little supervision
  • Willing and able to adapt to changes in work environment, procedures, priorities, schedule, and job duties

Preferred Education, Skills, & Experience

  • Knowledge of HIPAA requirements and regulations
  • Previous medical billing experience
  • Understanding of Medicare, Medicaid, commercial, liability and patient reimbursement/billing
  • Solid understanding of insurance and liability payment methods and regulations

Working Environment/Physical Requirements

  • General office environment
  • Typing, sitting, standing, walking, some light lifting
  • Use of basic office equipment such as computer, fax, printer, copier, telephone, scanner
  • Infrequently required to work extended hours without advanced notice due to business needs

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