[Hiring] Refund Specialist - Insurance @Savista

Role Description

The Refund Specialist-Insurance is responsible for reviewing accounts, identifying insurance overpayments and credit balances. Evaluates and verifies refunds are issued in accordance with current policies and procedures.

• Reviews refund/overpayment requests from insurance payers to determine if an overpayment has occurred.
• Reviews and resolves credit balances through credit transfers, account corrections, and refund request form completion for manual refund check requests.
• Identifies root causes and trends contributing to patient and insurance credit balances and works collaboratively with all areas of the revenue cycle to improve efficiency and eliminate these issues.
• Posts debits for approved refunds.
• Researches returned checks and collaborates with A/P for reporting to unclaimed property.
• Resolves Department credit balance inquiries for transfers and refund check requests.
• Ability to work collaboratively and build positive business relationships with clinical areas and the payer community.
• Understanding of electronic medical record / billing system Pricing Module and fee schedules.
• Develops expertise with payer specialty-specific payment policies, by using the payer assigned websites.
• Maintains and respects the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure.
• Performs other related duties as required.

Qualifications

• Bachelor’s degree in accounting, Business, Finance, or a related field, or an equivalent combination of education, training, and experience.
• Minimum of 3 years of experience in a healthcare or managed care environment, preferably within a large physician practice.
• At least 1 year of experience handling complex insurance refunds.
• Strong knowledge of physician reimbursement methodologies and managed care claim payment processes.
• Advanced proficiency in Microsoft Excel and financial analysis related to physician reimbursement.
• Strong analytical skills with exceptional attention to detail.
• Ability to provide clear, professional verbal feedback.
• Ability to follow and understand instructions and respond appropriately in various work situations.
• Demonstrates mental adaptability and flexibility when working with diverse individuals and changing priorities.

Requirements

• Note: Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $21.00 to $23.00. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills.

Company Description

SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.

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