Overview
The Refund Specialist II validates and tracks credits due to insurance companies, patients and other payers. The incumbent of this role is responsible for understanding payor contracts and preparing refund requests. This role may also be assigned to post payments and perform essential cash management duties.
At this time, US Anesthesia Partners does not hire candidates residing in New York, California, Hawaii, or Alaska.
Job Highlights
ESSENTIAL DUTIES AND RESPONSIBILITIES (include but not limited to):
- Reviews refund requests daily for completeness.
- Submits refund requests in good order for approval daily.
- Compiles and sends the necessary documentation for refund checks processing bi-monthly.
- Tracks essential check posting information.
- Updates the Credit Balance Spreadsheet daily when checks clear the bank.
- Compiles refunds that have cleared the bank for posting.
- Ensures all refund checks cleared within the posting month are gathered and delivered before monthly close.
- Performs follow-up on checks that have not cleared the bank, and research’s checks that are returned for insufficient address.
- Prepares Refund Request Forms and supporting documentation regarding overpayment calculations.
- Assists with audits of adjustments and payment posting.
- Daily/weekly/monthly balancing of all posting activity performed.
- Tracks renewal dates on all contracts via contracts calendar.
- Manages all incoming updated reimbursement summaries.
- Maintains HIPAA patient confidentiality standards for medical and financial information.
- Performs all other duties as assigned.
Qualifications
Knowledge/Skills/Abilities (KSAs):
- Highschool diploma or equivalent required.
- Minimum of three years of medical billing experience required.
- Knowledge of medical terminology and computer literacy are required.
- Familiarity with payor contracts.
- 2+ years posting experience.
- Basic office skills required; advanced office skills preferred.
- Strong working knowledge of Excel.
- Strong communication skills both oral and written.
- Accurate data entry skills.
- Attention to detail a must.
- Ability to identify trends in underpayments/overpayments.
*The physical demands described here are representative of those that may need to be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Occasional Standing
- Occasional Walking
- Frequent Sitting
- Frequent hand, finger movement
- Use office equipment (in office or remote)
- Communicate verbally and in writing
DISCLAIMER: The above job description has been written to indicate the general nature and level of work performed by employees within this classification. It is not written to be inclusive of all duties, responsibilities and qualifications required of employees assigned to this job.
US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factors.
