PATIENT REP IV-REFUND

Responsibilities

• Reviews work-queues for credit balances and determines resolution.
• Reports Medicare Credits to the Medicare Collection Associate for claim adjusting and files Quarterly report to Medicare.
• Researches and prepares refund requests and adjustments to correct account balances.
• Processes refunds/adjustments to the appropriate unit or clinic and recurring accounts.
• Codes accounts for unit billing payments, deductibles, coinsurance, co-pay, etc., for contract management system.
• Responds to customer phone calls regarding requests for refunds.
• Identifies and notifies Finance of unclaimed property to be turned over to the State.
• Reviews, logs, and reports on Medicaid Audits for possible billing to other payers.

Qualifications

• Accuracy rate of 95% must be maintained.
• Productivity requirement of 8.67 accounts per hour must be met.
• Knowledge of UB-92 and 1500 billing preferred.
• Must have working knowledge of insurance claim filing, collections, and established refund processing procedures.
• Ability to prioritize job functions, work independently, and exercise good judgment.
• Must possess good written and verbal communication skills.
• Must possess good organizational/analytical skills and mathematical aptitude.
• Proficient use of calculator and minimum typing (55 wpm).
• Basic personal computer skills.