Refund Specialist
Posted on: 1 Mar 2021
Sparks, NV
Job Description
Job Description
Responsibilities
The Refund Specialist is responsible for the accurate and timely resolution of the Practice Management System (PMS) self-pay and insurance credits. 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 team player. Upholds best practices in day to day processes and work flow standardization to drive maximum efficiencies across the team.
Qualifications
Education: High School Graduate/GED required. Technical School/2 Years College/Associates Degree preferred.
Work experience: Experience (3-5 years minimum) working in a healthcare (professional) billing, health insurance or equivalent operations work environment.
Knowledge: 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.
Skills: Excellent organization skills, attention to detail, research and problem solving ability. Results oriented with a proven track record of accomplishing tasks within a high-performing team environment. Service-oriented/customer-centric. Strong computer literacy skills including proficiency in Microsoft Office.
Universal Health Services
King of Prussia, PA
Universal Health Services, Inc. (UHS) is one of the nation’s largest and most respected healthcare management companies, operating through its subsidiaries, behavioral health facilities, acute care hospitals and ambulatory centers throughout the United States, the United Kingdom and Puerto Rico. UHS was founded in 1979 by Alan B. Miller, Chairman and CEO, and today has more than 87,000 employees. UHS maintains one of the strongest balance sheets and is rated among the highest in the hospital services industry by Moody’s and Standard & Poor’s. This strong capital position has enabled the company to develop and acquire many new facilities over the past few years.
The UHS strategy is to build or purchase healthcare properties in rapidly growing markets and create a strong franchise based on exceptional service and effective cost control. UHS owes its success to a responsive management style and to a service philosophy that is based on integrity, competence and compassion.
The healthcare industry remains a place of rapid change and uncertainty. But with strength, experience and foresight to chart its own course, UHS has every reason to face the future with optimism.
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IndustryHealthcare
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No. of Employees87,000
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Website
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Jobs Posted7367
