Patient Accounting Representative I - Reimbursement-Refunds

Job Qualifications

• Associate’s Degree in Accounting, Business Administration, Finance or at least two (2) years in a related field which can be substituted for a degree.
• Preferred minimum of two (2) years of healthcare experience in the area of reimbursement methodologies including managed care contracts, Medicaid and Medicare.
• Preferred knowledge of electronic remittance posting, interpretation of explanation of benefits, cash applications and batch posting processes.
• Preferred knowledge in third party billing and collections in a hospital setting.
• Excellent analytical, communication and organizational skills with strong attention to detail.
• Self-starter with the ability to work with minimal supervision.
• Proficient PC skills including Microsoft Outlook, Word and Excel.
• Must be able to function and meet deadlines under stressful conditions and prioritize work flow.

Job Duties and Responsibilities

• Processes third party and patient refunds in adherence with company policy.
• Researches credit balance accounts for possible refund or retraction.
• Reviews incoming refund requests, via mail or fax from insurance or audit companies, for validity and responds appropriately.
• Sends any necessary adjustments, posting corrections or payment transfers to the Payment Poster Specialist.
• Coordinates refunds/retractions with third party vendors working on behalf of Halifax Health in accordance with company policy.
• Compose letters or faxes disputing refunds to insurance or audit companies.
• Call insurance companies to obtain additional information concerning the credit balance.
• Complete audits from insurance companies or internal compliance in a timely manner.
• Submits refund posting report to the Accounting department weekly.
• Responds to system tasks in a timely manner.
• Contributes to effective working relationships by demonstrating a positive and helpful attitude with co-workers.
• Maintains privacy strictly adhering to HIPAA guidelines.
• Performs other duties as assigned