Refund Specialist I

🕒 4 dias atrás

🏈 Ohio – Remoto

🏈 Ohio – Remote

💵 $16 - $30 / hora

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

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US Acute Care Solutions

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 2015

🏥 Saúde

💊 Farmacêutico

📡 Telecomunicações

💰 Private Equity Round em 2021-02

Healthcare • Pharmaceuticals • Telecommunications

A US Acute Care Solutions é uma empresa de propriedade de médicos, especializada na gestão e fornecimento de serviços de atendimento agudo nos Estados Unidos. Com foco em medicina de emergência, medicina hospitalar e cuidados críticos, a USACS faz parcerias com sistemas de saúde para aprimorar o atendimento ao paciente e melhorar o contínuo de cuidados de saúde. Anualmente, a empresa atende mais de 10 milhões de pacientes e opera mais de 500 programas clínicos em 30 estados, impulsionada por um compromisso com a inovação, qualidade e prestação colaborativa de cuidados de saúde.

Descrição

• Thoroughly research patient accounts to identify and resolve overpayments • Process accurate refunds and correct posting discrepancies within the Athena Billing System • Investigate refunds and credit balances by reviewing unapplied payments • Verify payment application details on patient accounts • Analyze internal deposit and payment batches to trace deposit origins and detect duplicate postings • Use Cedar Patient Portal to confirm payment information and initiate refunds • Enter cases and document corrections within the Athena system • Perform guarantor-account adjustments and process refunds • Ensure claims are adjudicated correctly by understanding payer-side claim processes in Athena • Maintain comprehensive system notations for communication and account tracking • Execute refund check processes, including reissue, void, and returned checks • Maintain backup documentation for adjusted and refunded accounts for audit readiness • Communicate with coworkers, management, third-party payors, and patients • Assist with additional departmental duties as assigned

🎯 Requisitos

• High school diploma or equivalent required • Minimum of two years combined experience in medical insurance, payment processing, or insurance follow-up preferred • Experience with insurance websites, portals, and overpayment forms required • Strong knowledge of Coordination of Benefits, including government and commercial carriers required • Proficient in reviewing Explanations of Benefits and posting required • Strong knowledge of payer-initiated recoupments required • Experience with AthenaOne Billing System preferred but not mandatory • In-depth knowledge of payment processing functions, medical insurance, government payors, and related terminology • Proficiency with personal computers in a Windows environment, including spreadsheet applications and data-entry tools • Strong attention to detail and problem-solving skills • Effective verbal and written communication skills with professionalism and confidentiality • Ability to organize workload, manage multiple tasks, and adapt to changing priorities • Willingness and ability to work overtime as needed • Ability to sit for extended periods and occasionally walk, stand, bend, stoop, and lift up to 15 pounds • Close visual acuity required to perform duties accurately

🏖️ Benefícios

• Medical, dental, and vision insurance options • Health savings accounts (HSA) and flexible spending accounts (FSA) • 401(k) employee and employer contributions • Paid time off, including vacation, sick leave, and company holidays • Paid parental leave & family support benefits • Short-term and long-term disability insurance • Life and accidental death & dismemberment (AD&D) insurance • Employee assistance programs & wellness resources • Bonus eligibility, equity, or other incentive programs, depending on the role • Supportive culture • Competitive compensation package • Unlimited paths for advancement