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Refund Specialist

Wellington Regional Medical Center

Refund Specialist This role requires a 3 month training period in the King of Prussia, PA headquarters. Independence Physician Management (IPM), a subsidiary of UHS, develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve. Position Overview: The Refund Specialist is responsible for the accurate and timely resolution of the Practice Management System (PMS) self-pay and insurance credits. Duties and Responsibilities: Thoroughly researches credit balances to determine if an overpayment occurred and initiates the refund process accordingly outlining the reason for the refund and including explanation of benefits (EOBs), if needed. Handles payer refund requests including validating the refund following review of the account history and submission of a refund request to Accounts Payable. Meets or exceeds established performance targets (productivity and quality) established by their supervisor. Partners with the Reimbursement Specialists, as needed, to research accounts and validate self-pay and insurance refunds. Maintains a working knowledge of CPT-4 and ICD-10 coding principles, government, managed care and commercial payers, payment posting, ERA processing, claim adjustment reason codes, contractual adjustment, copays, coinsurance, and deductibles. Demonstrates the ability to be an effective collaborator. Upholds "best practices" in day-to-day processes and workflow standardization to drive maximum efficiency across the team. Qualifications: High School Graduate/GED required. Technical school or associate degree preferred. Experience (3-5 years minimum) working in a healthcare (professional) billing, health insurance or equivalent operations work environment. Healthcare (professional) billing, knowledge of CPT/ICD-10 coding, claim submission requirements, payment posting and remittance processing. Understanding of the revenue cycle and how the various components work together preferred. Excellent organization skills, diligence, research and problem-solving ability. Results oriented with a proven history of accomplishing tasks within a high-performing team environment. Service-oriented/customer-centric. Strong computer literacy skills including proficiency in Microsoft Office. Billing software (e.g., Cerner, Epic, IDX) experience highly desirable. As an IPM employee you will be part of a first-class organization offering: Challenging and rewarding work environment Competitive Compensation & Generous Paid Time Off Excellent Medical, Dental, Vision and Prescription Drug Plans 401(K) with company match and discounted stock plan Tuition Reimbursement and much more! EEO Statement: All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

Vacancy posted 2 hours ago
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