Job Description
Consociate Health, a leading Third-Party Administrator, offers an opportunity to grow and develop your career in an environment that provides a fulfilling workplace for employees, and creates continuous learning and embraces the ideas and diversity of others.
As part of our Mission to make Healthcare more accessible and affordable for our clients through innovation solutions and expert consultation, we value the inherent qualities that are foremost in our Mission, Vision, Values- Compassion, Humility and Impact, which allow us all to create authentic relationships with our team and our clients.
Position Summary:
The Refund Specialist reports to the Claims Manager. This position is responsible for handling the processing of voids and refunds.
Principal Duties & Responsibilities:
- Processes all voids and refunds
- Handles all stop payments
- Coordinates refunds with Finance department
- Maintains refunds at a 30-day TAT
- Performs other duties as assigned
General Expectations:
- Present a positive image of Consociate Health at all times.
- Provide and promote the delivery of services with a prevailing attitude of respect and recognition of the personal worth and dignity of every individual whether they are a client, coworker, or supervisor.
- Communicate in a clear and concise manner, while also demonstrating receptivity through active listening.
- Identify and perform work that has not been specifically assigned, as needed.
- Adheres to established safety standards and utilizes proper techniques to avoid work-related injuries.
- Continuously seek opportunities for improvement and suggest ways in which procedures/systems may be modified to accomplish tasks/goal efficiently and effectively.
- Demonstrate a teamwork philosophy by working cooperatively with others inside and outside the Claims Department.
- Attend required in-service and staff meetings.
- Preserve the confidentiality of all business-sensitive information, including but not limited to that of insured groups, individuals and employees.
Service Expectations:
- Greet all people in a prompt and courteous manner. Communicates in a warm and courteous manner, making eye contact and speaking in a tone of voice that matches words.
- Respond to client requests in a timely manner, returning calls promptly and keeping them informed of delays before they ask.
- Take appropriate steps to resolve problems to the clients satisfaction.
- Seek opportunities, provide value-added services, and eliminate tasks that do not serve our clients or staff.
- Remain aware of products and services provided by Consociate Health.
- Project a positive, professional image when working.
Experience and Skills
Knowledge, Skills and Ability Requirements:
- High School Education required.
- Claims Processing Experience required. Experience processing claims adjustments and refunds preferred.
- Minimum of one to three years of experience working with the public. Previous insurance billing or customer service background recommended.
Physical and Mental Abilities:
- Ability to perform sedentary work for extended periods of time.
- Ability to utilize personal computer (manual dexterity is required to operate a keyboard), telephone system, and communicate with a variety of customers.
- Ability to concentrate, meet deadlines, work on several projects during the same period, and adapt to interruptions.
Reporting Structure:
- Reports to the Claims Manager
Working Conditions:
- Work is performed remotely.
- Overtime as needed may be requested.
Benefits:
- Paid time off
- Paid Holidays
- Medical, Dental and Vision Insurance
- Basic Group Life, Short Term and Long Term Disability
- Voluntary Life, Critical Illness and Accident Coverage
- 401K Plan: Employees are immediately eligible with a 2% automatic enrollment. Consociate matches up to 4% of an employees' annual salary.
