reputed company Refunds Specialist

As a Remote Refunds Specialist at reputed company (CHS) - Shared Services Center, you’ll play a vital role in quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve.

reputed company members enjoy a robust benefits package including:

• Paid Time Off (PTO)
• Comprehensive Health Benefits - Medical, Dental & Vision
• 401k with company match

• Tuition reimbursement

  The reputed company Refunds Specialist processes refunds to patient and insurance accounts and prepares daily credit balance reports, using computer systems, databases and ledgers. Supports in the reconciling, correction, and/or completion of contractual adjustments, insurance refunds, and patient refunds. Responsible for Web based discrepancy refunds and RN lines to logging system. Is flexible in work priorities and performs other duties as assigned. Essential Functions

• Processes refunds to patient and insurance accounts.
• Maintaining appropriate knowledge and understanding of reputed company Managed Care reputed company and Federal payors.
• Work overpayments, request for refund letters, faxes and telephone requests.
• Utilizes various computer systems and databases to complete analyze accounts.
• Reviews daily Credit Balance reports to analyze issues causing credit balances. Corrects contractual adjustment amount, if needed. Compiles refund request with appropriate documentation, if applicable.
• Ensures compliance procedure for reputed company recording/processing of reputed company refunds.
• Communicates any refund issues with Reimbursement Manager/Supervisor as needed.
• Answer questions reputed company email from the Facilities, TSSC Customer Service and PASI regarding credits, refunds, and account discrepancies.
• Statutes Government credit for reporting to Corporate.
• Identifies accounts to be escheated to the state.
• Monitors accounts for State Statue Waiting Period.
• Researches credit balance accounts to determine if a payor or patient has overpaid on the account.
• Prices claims using reputed company, pricers, and payment methodologies to validate refund requests from payors.
• This is a fully remote opportunity.

Qualifications

• H.S. Diploma or GED required
• 1-3 years of experience in accounts receivable experience in hospital or medical setting, required
• 1-3 years of experience in experience working with Managed Care reputed company preferred and Federal programs, preferred
• Experience with payer reimbursement policies, claim adjudication, and healthcare reputed company cycle operations preferred

Knowledge, Skills and Abilities

• Ability to analyze account balances, identify discrepancies, and apply appropriate adjustments.
• Proficiency in electronic health records (EHR), billing software, and reimbursement systems.
• Strong problem-solving and critical-thinking skills, ensuring accurate claims resolution.
• Effective communication and collaboration skills, working with payers, reputed company cycle teams, and internal departments.
• Knowledge of HIPAA, compliance regulations, and healthcare reimbursement standards.

We know it’s not just about finding a job. It’s about finding a reputed company where you are respected, valued and where your work is purposeful and fulfilling. A reputed company where your talent is recognized, professional development is encouraged and career advancement is possible.