2 Refund Specialist: Insurance Claims Jobs in Federal Way, WA
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TalentBurst, an Inc 5000 company is Hiring a Refund Specialist: Insurance Claims Near Federal Way, WA
Our client is currently looking for a Refund Specialist for our Credits Team in our Revenue Operations Department. Individuals who excel in this role are highly ambitious, results driven, and willing to "think outside the box."
This position requires a high level of attention to detail and the ability to work well as part of a fast paced team. The ideal candidate has a high level of multitasking abilities, strong mathematical and analytical skills, and is driven by resolving open balances with the goal to prevent future rework. In this position, you will analyze EOBs and/ or payor correspondence to reconcile system credit balances or potential overpayments, research and resolve problem accounts, and request adjustments. You will effectively identify trends and analyze root causes to drive work efficiently within the team. Hybrid and remote position available. All necessary equipment is provided.
Essential Duties And Responsibilities
- Autonomously research, initiate follow-up and resolve all health care insurance claim accounts with existing credit balances (claim(s) paid more than expected by payer); actions included but not limited to initiating refund packets, retractions, and/or adjustments to claims
- Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution of claims
- Use critical thinking, root cause analysis, and problem solving skills to resolve issues on outstanding claim balances
- Uses strong organizational skills to effectively manage large amounts of detailed information
- Utilizes excellent written and oral communication skills to collaborate and maintain positive working relationships with peers, leaders, clinical personnel, and payer representatives to resolve credit balances.
- Contributes to implementation of process improvement initiatives aimed at improving credit department
- Ensures compliance by using established internal control procedures by examining records, reports, operating practices, and documentation
- Stay current on communications relating to healthcare reimbursement and regulatory changes
- Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and client policies
- Understand and adhere to all policies, laws and regulations applicable to this role
- Consistent, regular, punctual attendance as scheduled is an essential responsibility of this position
- Participate in group settings and team work environment
- High School Diploma or equivalent required
- Healthcare and medical claim overpayment remediation and refunding experience is required
- 2-4+ years' experience with accounting, transactions, or medical billing/accounting systems required
- Knowledge or experience working with a variety of health care insurance payers is preferred
- Intermediate computer proficiency in Microsoft Office including Excel and Outlook- required
- All necessary workstation equipment
First 120 Days
- PST: 8 am – 4:30 pm
- MST: 8:30 am – 5 pm (7:30 – 4 PM PST)
- CST: 8:30 am – 5 pm (6:30 am – 3 pm PST)
- EST: 9 am – 5:30 pm (6 am -2:30 pm PST)
Work Environment: Hybrid or Remote. Role requires a stationary, designated, and HIPPA Compliant workspace. Traveling with equipment is not permitted.Sonar Refund Specialist
TB_EN Job #: 24-08082
Job Summary
Contractor
IT Outsourcing & Consulting
$45k-53k (estimate)
05/20/2024
06/06/2024
talentburst.com
BOURNE, MA
25 - 50
2002
JOE CLERICO
<$5M
IT Outsourcing & Consulting
Related Companies
About TalentBurst, an Inc 5000 company
TalentBurst is a certified MBE staffing/payroll firm founded in 2002 by 3 ex-Monster.com executives. We provide award winning solutions for the Global Talent Cloud including: IT, Engineering, Professional, & F&A Staffing Life Sciences & Clinical Staffing High Hazard & Global Payroll 1099/IC Validation & Compliance Our MSP partners & end customers have recognized us with the following awards: AgileOne Gold Supplier 2017 Allegis Global Solutions Strategic Partner 2018, 2019, 2020, 2021 Allegis Global Solutions Diversity Partner of the Year 2020 Geometric Results Platinum Preferred Partner KellyO...CG #1 Strategic Supplier @ #1 Cloud Computing PRO Unlimited Silver, Gold, & Platinum Supplier 2012 - 2020 Randstad Premier Supplier 2021 TAPFIN Premier Partner 2017, 2018 TAPFIN Program Performance Award @ #1 cloud computing Workforce Logiq Proven Performer 2016 - 2020 First Data #1 supplier for 12 Quarters Thermo Fisher Supplier of the Quarter Toyota Best in Compliance and Retention Excellence Dominion Energy Supplier of the Year 2020 Western Union Supplier of the Year 2017 2020, 2021 BBJ Fast50 10 time BBJ "Pacesetter & INC 500/5000 5 time SIA-fastest growing SIA 2020 Large Life Sciences Staffing Firms GENMSDC "Supplier of the Year" Category 4 2019, 2020 Top 3 Supplier for Sanofi, Visa, Adobe, Securian Top Supplier for First Data for 10 years We currently have workforce in 46 states and 8 countries working for customers such as Amazon, Uber, VISA, Exelon, Securian, Salesforce.com, Dropbox, Twitter, Verizon Media, Adobe, Western Union, First Data, FIS, National Grid, SANOFI, Merck, Abbott, Roche, Symantec, and Corning among many others. We are headquartered in Natick, MA along with operations in San Fran, CA; Fort Lauderdale, FL; Vineland, NJ; Providence, RI, Raleigh, NC, Toronto, Canada; & Gurgaon, India as well as remote Executives strategically placed nationwide. Please check us out at www.TalentBurst.com or via Linkedin or Facebook.
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