Refund Processing Representative I - Part Time
Company: Advocate Health
Location: Milwaukee
Posted on: May 6, 2024
Job Description:
Major Responsibilities:
- Responsible for analyzing and resolving credit balances and
requests for refunds within all AAH Hospital Billing entities and
Professional Billing within multiple patient accounting systems and
ensure appropriate contract reimbursement calculation rates are
applied.
- Utilize multiple systems to review credit balances as assigned
to determine the appropriate course of action needed to accurately
resolve.
- Determine payor creating overpayment credit, verify
coordination of benefits, reimbursement calculations and payment
source and follow the appropriate system process and department
procedures to resolve.
- Identify and report root cause of credit balances and payer
refund trends; partner with internal and external
counterparts.
- Document patient account notes and Guarantor account notes with
all actions taken to resolve credit or refund requests.
- Possess knowledge of the Refund/Adjustment processes and
utilizes systems/applications proficiently in order to resolve
credit balances and process refunds appropriately. Contribute to
improvement initiatives and department/system goals.
- Adheres to established Advocate Aurora Health Revenue Cycle
policies, procedures, guidelines and productivity standards and
responsible for maintaining personal growth and development.
- Responsible to read and understand all AAH Revenue Cycle
policies and departmental policies and procedures.
- Assists level II's in completing ad hoc projects and related
job activities as assigned to support department operations. During
periods of high volume and/or impending deadlines, assignments may
include assisting with patient accounting activities and functions
typically performed by other Revenue Cycle positions.
- Acquires and maintains knowledge of all healthcare and
insurance regulations, local, state, and federal legislation and
regulatory agencies and activities which may affect Revenue Cycle
operations.Licensure, Registration, and/or Certification Required:
- None Required.Education Required:
- High School Graduate.Experience Required:
- Typically requires 1 year of experience in healthcare business
office setting.Knowledge, Skills & Abilities Required:
- Good organizational ability and communication skills (written
and verbal).
- Ability to read, enter and retrieve information from multiple
patient accounting systems.
- Basic understanding of Microsoft Office
- Basic bookkeeping skills and a strong mathematics
aptitude.
- Able to work independently, under pressure in a fast paced
environment.
- Strong attention to detail and maintains high degree of
accuracy.
- Managed Care payer contract terms and Medicare/Medicaid payer
guidelines.
- Ethical conduct.
- Regular and reliable attendance.Physical Requirements and
Working Conditions:
- Must be able to sit the majority of the workday.
- Exposed to a normal office environment.
- Operates all equipment necessary to perform the job.This job
description indicates the general nature and level of work expected
of the incumbent. It is not designed to cover or contain a
comprehensive listing of activities, duties or responsibilities
required of the incumbent. Incumbent may be required to perform
other related duties.
Keywords: Advocate Health, Appleton , Refund Processing Representative I - Part Time, Other , Milwaukee, Wisconsin
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