RCM Refund Specialist

Processing of patient and insurance refunds.

Responsibilities include, but are not limited to, the following:

• Review credits and research patient accounts for both Patient and Insurance. Determine if there is a true credit for patient or Insurance by verifying payment method and pulling remits.
• Adjust small balances and convey monies.
• Issue patient credits by writing Refund checks. Prepare the refund checks with detailed reports for Management to review and obtain signature.
• Run financial reports for accounting to review.
• Prepare and mail checks.
• File corresponding copies as backup.
• Process Returned refunds with accounting department. Attempt contact with patient to re-send refund.

Other

• Maintains patient confidentiality; complies with HIPAA and compliance guidelines established by the practice.

• Maintains detailed knowledge of practice management and other computer software as it relates to job functions.
• Attends OSHA, HIPAA, and OIG training programs as required.
• Attends all meetings as requested including regular staff meetings.
• Performs any additional duties as requested by the Director of Central Billing Services and/or Manager or Team Leader/ Supervisor.
• Completes all assigned AP training (such as CPR, OSHA, HIPAA, Compliance, Information Security, others) within designated timeframes.
• Complies with Allergy Partners and respective hub/department policies and reports incidents of policy violations to a Supervisor/Manager/Director, Department of Compliance & Privacy or via the AP EthicsPoint hotline.

Supervisory Responsibilities

This job has no supervisory responsibilities.

Typical Physical Demands

Physical demands are moderate with occasional lifting of items weighing approximately 20-30 pounds. Position requires prolonged sitting, some bending, stooping, and stretching. Good eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment is also required. Employee must have normal range of hearing and vision must be correctable to normal range to record, prepare, and communicate appropriate reports.

Typical Working Conditions

Normal office environment. Occasional evening or weekend work.

EDUCATIONAL REQUIREMENTS:

• High school diploma or GED equivalent. Healthcare or related experience required.

QUALIFICATIONS AND EXPERIENCE:

• One to three years of experience, preferably in a healthcare billing setting
• Good communication skills, both written and oral
• Proficient computer skills including word processing, and data entry
• Must have ability to communicate professionally and effectively with management and co-workers
• Detail oriented with the ability to detect errors and discrepancies
• Ability to work independently and stay focused on task at hand