PRI-Refunds Representative

Job Overview Position: PRI‑Refunds Representative Location: Stuart, FL Employment Type: Contract on W2 (US Citizens or Green Card holders required) Work Hours: 8‑hour shift 7:00 am–5:00 pm EST, mandatory overtime during last week and weekends of the month as business needs. Duration: 12‑month contract Responsibilities Process medical billing claims, collect patient or provider payments, and resolve account questions. Process patient refunds and appeals including re‑determinations and resubmissions to payers. Identify and complete overpayment, offset/recoupment, and refund requests for payers and patients. Investigate payment denials, determine causes, and rectify issues with payers or patients. Review returned supplies to determine exchange, partial or full product returns. Complete claim adjustments or voids to ensure accurate billing records. Receive inbound and place outbound calls with customers, Medicare, Medicaid and commercial insurance providers. Respond to audit requests and provide required documentation. Document billing and payment status in patient accounts for follow‑up. Maintain knowledge of payer rules through research and coaching. Answer patient calls about billing questions. Complete end‑of‑month reports and internal system service tickets. Participate in miscellaneous projects as needed. Ancillary Responsibilities Maintain a positive work atmosphere embodying professional excellence, teamwork, and integrity. Process 20–40 accounts per day with high quality. Maintain attendance as per management standards. Minimum Requirements High school diploma or GED. 2–4 years prior medical supply billing experience or 1–3 years as an AR Billing Representative. Ability to read and interpret medical supply publications and write business correspondence. Strong math skills, including calculation of percentages and intermediate math concepts. Problem‑solving and analytical reasoning abilities. Proficient in Microsoft Office and database applications. Experience with call center telecommunications software. Ability to work some evening shifts, weekends, and overtime. US citizenship or valid Green Card holder. Physical & Work Environment Occasional light lifting up to 10 lbs. Work in a temperature‑controlled office with moderate noise levels. Legal Disclaimers Job description reflects general duties; additional duties may be assigned. Reasonable accommodations provided for individuals with disabilities. #J-18808-Ljbffr MillenniumSoft Inc