Job Description

Job Title: Refund Analyst

Department: Revenue Cycle

Reports To: Accounts Receivables Manager

Job Summary:

This position is responsible for researching patient and insurance credit balances in an efficient, accurate and timely manner. Must have in depth knowledge and understanding of (EOBS) explanation of benefits, understanding of patient accounting, experience working in a practice management system, attention to detail, accurate typing skills, excellent interpersonal skills, communication skills, basic math and spreadsheet skills, such as Microsoft Excel

Job Responsibilities include:

• Review credit balances on accounts to determine source and validity of overpayment.
• Research claim payment and adjustment history to validate refund requests.
• Work credit balance worklist daily ensuring timely acknowledgement of refund requests.
• Thoroughly investigate all payments and adjustments posted to accounts to validate receipt of revenue and accuracy.
• Collect and record all source documents reviewed to validate approved refund or recoupment requests along with comprehensive account notation.
• Thoroughly review claim processing history and work with claims department to respond to recoupment requests.
• Work directly with insurance companies to settle validated recoupment requests in the most effective manner.
• Follow-up to ensure approved refunds are processed.
• Assist in handling payer and patient questions and concerns.
• Be flexible in assuming other appropriate responsibilities not noted above.

Requirements:

Education - High School Diploma.

Experience - 1-3 years of investigating and processing refunds (healthcare setting), in depth understanding of EOBS (required), in depth understanding of insurance recoupments (required) experience working with Meditech (bonus)

Licensure - CPB or CMRS certification(bonus)

Physical Requirements - Lifting up to 50 pounds, standing or sitting for extended periods of time, as well as repetitive use of hands and fingers.

• = Essential functions

Cayuga Health System Commitment to Diversity, Equity & Inclusion

Cayuga Health System commits to treat all people with dignity so that everyone who comes to us is safe, cared for, and respected. We will support the growth of our employees and the health of our community by embracing the rich diversity of social and cultural identities, needs, and life circumstances of all people. We strive to recognize and overcome personal biases and systemic policies that marginalize others and contribute to disparities in healthcare access, equitable care, and good health outcomes.