Refund Specialist

Location Administration 6210 US-290 E Austin, TX 78723, USA Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas’ largest professional medical groups with 35+ locations and we are continuing to grow. We offer the following benefits to eligible team members: Medical, Dental, Vision, Flexible Spending Accounts, PTO, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health & Fitness, Sick Child Care Assistance, Development and more. For additional information visit

PURPOSE

Performs all duties required to ensure accurate distribution of patient/insurance payments and appropriate adjustments to patient accounts. Carries out all duties while respecting patient confidentiality and promoting the mission and philosophy of the organization supported.

ESSENTIAL FUNCTIONS

Audits patient accounts to resolve all credits and undistributed activity. Thoroughly researches and resolves all credits as assigned through daily distributions and reports. Reviews carrier explanation of benefits to determine accurate reflection of carrier, provider and patient responsibility. Opens payment posting or adjustment batch to perform appropriate account maintenance activity to appropriately balance claim activity. Accurately distributes or redistributes payments and adjustments to correct invoice and date of service. Generates any adjustments necessary to complete correct posting of payments and adjustments using appropriate A/R and ANSI codes. Ensures accurate transfer of outstanding balances to next responsible party as indicated by payer explanation of benefits. Assists with training of new employees. Compiles and submits patient and insurance refunds according to established policy and procedure with all supporting documentation. Reviews and files all secondary insurance claims attaching carrier explanations of benefits for designated plans. Completes clear and accurate account notes to document issue, source and resolution of all account maintenance activity. Obtains supervisor signature on all large dollar write-offs according to established policy. Follows established guidelines to complete all report activity to meet month end deadlines. Documents daily performance in weekly productivity log. Researches and processes patient credit card refunds in Epic. Distributes daily credit batches to staff. Assists and processes Agency notifications. Efficiently and effectively maintains work queues to perform necessary account maintenance processes according to established policy and procedure. Utilizes all payer web site systems & tools to obtain accurate patient eligibility and claim payment details. Attends meetings as requested. Adheres to all company policies, including but not limited to, OSHA, HIPAA, compliance and Code of Conduct. Maintains regular and dependable attendance. Follows the core competencies set forth by the Company, which are available for review on CMSweb.

OTHER DUTIES AND RESPONSIBILITIES

Keeps complete, accessible, dated files. Identifies training needs of the Team and works with the Team Leader and Supervisor to provide. Aids coworkers as requested and/or necessary. Provides workload statistic reports to management team. Responds professionally and effectively to questions from external sources, i.e., customer or carrier, and internal sources, i.e., provider or management team. Attends required in-services/training. Assists with training staff. Performs other duties as assigned.

QUALIFICATIONS

Education: High school diploma or GED equivalent. Skills/Experience Required: at least 1-2 years of related experience working with medical billing in a practice facility setting. Preferred: Prefer knowledge of and experience in ANSI denial codes. Preferred: Prefer knowledge of and experience in effective use of CPT, ICD-9 and HCPCS coding. Ability to sit for extended periods of time at a computer workstation. Prefer knowledge of legislative and private sector third party regulations and guidelines. You must have excellent verbal and written communication skills in order to communicate clearly and effectively to all levels of staff and the public. Accurate Ten key by touch. Basic knowledge of accounting and banking practices. Certificate/License: None Knowledge, Skills and Abilities Ability to engage others, listen and adapt response to meet others’ needs. Ability to align own actions with those of other team members committed to common goals. Excellent computer and keyboarding skills, including familiarity with Windows. Excellent verbal and written communication skills. Ability to manage competing priorities. Ability to always perform job duties in a professional manner. Ability to understand, recall, and communicate, information. Ability to organize thoughts and ideas into understandable terminology. Ability to apply common sense in performing job. Ability to focus on win-w… communication when conflicts, problems, or misunderstandings arise. Ability to organize and prioritize own work schedule. Work Schedule: Monday - Friday 8:00am - 5:00pm Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. #J-18808-Ljbffr Covenant-Management-Systems,-L.p.