What are the responsibilities and job description for the Patient Account Specialist- Credit Balance/ Refunds position at Oklahoma Heart Hospital?
Overview
Join Our Team at Oklahoma Heart Hospital (OHH)
ONE TEAM. ALL HEART. At OHH, we believe that patient care is truly at the heart of everything we do. Our dedicated team members are involved in every step of our patients’ journeys, bringing hope, compassion, and healing to both patients and their families. Together with our physicians and caregivers, we’re shaping the future of heart care in Oklahoma by serving the state and leading the nation.
Why You'll Love Working Here:
- Comprehensive Benefits:
- Medical, Dental, and Vision coverage
- 401(k) plan with employer match
- Long-term and short-term disability
- Employee Assistance Programs (EAP)
- Paid Time Off (PTO)
- Extended Medical Benefits (EMB)
- Opportunities for continuing education and professional growth
Please note that benefits may vary by position, and some roles (like PRN, Flex, Float, etc.) may have exclusions. For eligible positions, benefits start on your first day!
We can’t wait for you to join our heart-centered team!
Responsibilities
Insure payments and contractual adjustments are credited/ refunded in a timely and accurately fashion and according to department standards using various methods. Identify and process Insurance Denials and Appeals in accordance with Payer contract and Hospital Policies and Procedures. Supervises no employees. Makes independent decisions as to the management of accounts. Requires extensive contact with the public and employees. Handles confidential information. Performs all work in accordance to the mission, vision and values of Oklahoma Heart Hospital.
- Identify and process Insurance Denials and Appeals in accordance with Payer contract and Hospital Policies and Procedures
- Report repeated payment discrepancies to management timely.
- Using Credit Balance Report, promptly identify and research credit balances and overpayments to insure timely refunding of any confirmed overpayment for Federal and Non-Federal payers.
- When notified a refund is due to a payer or patient (support documentation provided) by co-worker, refund request is completed within 24 hours and to Director for approval.
- File Medicare Credit Balance Report Quarterly in accordance with CMS (Medicare) guidelines and Hospital Policy and Procedures.
- Review contracting guidelines to determine the proper handling of refund requests.
- Work closely with insurance companies as well as internal departments.
Qualifications
Education: High school diploma; prefer some college
Experience: One (1) year job related experience in Health Care required. Knowledge of credit balance/ refunds, including Medicare, Medicaid and commercial insurance required. Excellent Customer Service background. Good investigative skills and telephone techniques. Accurate and detailed oriented. Must have good oral and written communication skills. Proven organization skills needed.
Working Knowledge: Must be proficient on a personal computer and have experience with Microsoft Office including Excel and Word.
As part of our team, you are empowered to work collaboratively with our physicians and other caregivers, and play an integral role in setting the standard for excellence in patient care. Every team member at OHH plays an integral role in our patients’ experience. They are the reason OHH continues to serve the state and lead the nation. Be part of the future of cardiac care.