Refund Specialist

UPMC · Pittsburgh, PA · 3 days ago

AccountingFull-time

Process all credit balances (insurance and self-pay) for refunds.

Review credit balances for possible distribution to other debit balances
Ensure that all validated Government payer refunds are processed in a timely manner or within the payer guidelines
Maintain department productivity guidelines
Ensure that proper documentation is attached to all refund requests
Perform duties and job responsibilities in a manner which promotes the core values of UPMC (Quality and Safety, Dignity and Respect, Caring and Listening, Excellence and Innovation, Responsibility and Integrity) in all consumer and UPMC interactions
Maintain compliance with quality standards
Prioritize workflow accordingly by balance and aging criteria
Ensure that all incoming refund requests, either via CRM or email, are processed within 3 business days
Identify and take action towards resolution of credit accounts through potential refunds, adjustments, payment transfers, etc.
Adhere to the Fair Debt Extension Uniformity Act and understand the laws and regulations applicable to job functions
Identify credit balance issues that may impact workflow
Reconcile refund postings
Notify management of any trends identified in workflow creating credit balances

High School diploma or equivalent and 1 year of claims processing, billing or collections experience, OR High School diploma or equivalent and 3 years experience in a business office setting
Bachelor's degree is preferred
Knowledgeable in third party payer guidelines and reimbursement practices required
Effective problem solving skills and ability to make independent decisions required
Good oral and written communication skills
Knowledge of medical terminology, third party payer guidelines and reimbursement practices
Experience or working knowledge of Microsoft Office products (Word, Outlook, Excel) preferred but not required
Strong understanding of all patient accounting systems

Similar jobs