Refund Specilaist I
Research and process refunds in a timely manner following established department procedures in accordance with State and Federal laws.
- Regular, punctual attendance.
- Advanced understanding of systems in order to execute processes independently
- Fundamental computer knowledge
- Read and reply to email in a timely manner as needed.
- Listen and respond to voicemail in a timely manner as needed
- Provide supervisor with work progress reports on a daily, weekly, monthly basis or as required
- Comprehensive knowledge of billing process in order to correctly identify, assess, and research and correctly process credit balances.
- Comprehension of refund department processes in order to understand the concepts behind the process for implementation
- Comprehensive understanding of Medicare Remittance Advice processing rules
- Comprehensive understanding of secondary payers remittance advice processing rules
- Comprehensive understanding of secondary payer processing rules in order to contact secondary insurances for account resolution
- Research and track recoupments/offsets to appropriate beneficiaries
- Comprehensive knowledge of the adjustment process in billing software
- Comprehensive knowledge of the cash posting process in billing software Understand general mailing requirements
- Maintain department production goals while practicing flawless execution Understand their role and impact they have in the departmental team; including exhibiting positive attitudes, willingness to help wherever asked, staying focused and on task to the matter at hand, and being part of the success of your team Performs other duties as assigned.
- One year relevant work or educational experience
- Ability to recognize the need for escalation Proficient PC skills
- Demonstrates excellent problem-solving skills Willingness and ability to participate in all required training programs
- Working 10-key and/or keyboarding skills
- Proficiency in general office duties Ability to prioritize Attention to detail
- Ability to enter data accurately Demonstrate good interpersonal skills
- Ability to maintain complete confidentiality and discretion in business relationships
- Demonstrate willingness and ability to participate in, and complete, all required training programs
- Ability to work effectively and exercise sound business judgment in a team environment, as well as independently
- Demonstrate flexibility in work shift to meet department needs
- Demonstrate ability to deal effectively with all employees and external business contacts while conveying a positive service-oriented attitude
- Perform duties in an accurate and complete manner evaluated and validated via quality assurance assessment High School Diploma or equivalent
- Ability to communicate effectively, both verbally and in writing, with all levels of external and internal customers
- Ability to work under pressure and meet deadlines
- Ability to work at computer and maintain constant keyboarding status
- Six months general office experience preferred.
- Six months proven above average performance within KCI
- Excellent PC skills to include Excel and Word
- Ability to work in a team environment as well as independently
- Related Experience or Education in Financial Field
- This position reports to Refund Supervisor
- This position supervises/manages no other employee
- Working conditions are typical of a general office environment.
- May require long periods of sitting or standing.
- Overtime may be required as deemed necessary by business objectives.