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Refund Specialist

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JOB SUMMARY

The Refund Specialist for Value-Based RCM, Inc. (VBRCM) is responsible for reviewing and analyzing credit receivable balances on patient accounts, accumulating supporting documentation for resulting adjustments, and ensuring refunds to patients and insurance companies are processed and issued timely and accurately.

MAJOR AREAS OF FOCUS

  • Refunds

  • Customer Service

RESPONSIBILITIES

  • Use, protect, and disclose patient protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

  • Exhibit professional behavior and communication skills representative of VBRCM's commitment to superior customer service

  • Review patient accounts to ensure payments are applied correctly and the credit balance is valid

  • Identify and resolve credit accounts through refunds, adjustments, transfers, etc.

  • Research, audit and process refunds to patients and insurance companies

  • Answer customer questions regarding the refund and billing process

  • Correspond with insurance companies regarding documentation and billing information

  • Review refund documentation for accuracy and completion

  • Contribute to the improvement of billing procedures and processes; notify management of any trends identified in workflow creating credit balances

  • Perform other duties as assigned

KNOWLEDGE AND SKILLS

  • Proficient in Microsoft Office

  • Knowledge of third-party payer operating procedures, medical reimbursement policies and terminology

  • Excellent communication skills

EDUCATION AND EXPERIENCE

  • High school diploma or GED required

  • Minimum of 2 years Healthcare Billing experience required

JOB LOCATION

Remote

PHYSICAL REQUIREMENTS

  • Prolonged periods sitting at a desk and working on a computer

  • Must be able to lift up to 15 pounds at times

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