Refund Specialist in Middlebury, Connecticut at Waterbury Hospital

Position Summary:

The Refund Specialist plays a crucial role in ensuring accurate and timely reimbursement for healthcare services. This position involves working closely with patients, providers, and insurance payers to resolve billing issues and process refunds. Responsible for researching credit balances and managing refunding overpayments to patients or insurance companies.

Education /Certification:

• Associate’s degree preferred. High School diploma with significant experience may be considered.

Experience:

• Minimum 2 years of medical office experience with exposure to medical billing practices and customer service experience.
• Billing knowledge of government and multiple third-party payers.

Essential Duties and Responsibilities:

• Research and investigate denied or underpaid claims to identify reasons for discrepancies.
• Communicate with patients and/or providers to gather necessary documentation and address inquiries regarding refunds.
• Analyze complex billing scenarios and identify errors or omissions.
• Properly note and maintain accurate documentation of refund processes.
• Provide tenacious follow-up to ensure proper refunds are completed on a timely basis.

• Work correspondence received from insurance companies, notifications via email from reimbursement specialists
• Collaborate with other departments within the organization to ensure smooth functioning of the refund process.
• Accurately apply refund payments to the patient’s accounts
• Process any special client refund audit projects

Competencies:

• Must be self-motivated with the ability to multi-task.
• Proficient in analyzing data to determine the next steps for handling overpayments.

• Ability to report and present trends.
• Strong understanding of medical billing and coding principles.
• Knowledge of healthcare insurance policies and regulations.
• Excellent communication and interpersonal skills.
• Strong analytical and problem-solving abilities.
• Attention to detail and accuracy.
• Proficiency in relevant software applications, such as patient billing systems, electronic health records, Credit Card platforms, Microsoft Word, and Excel.

TYPICAL PHYSICAL DEMANDS: The physical demands describe here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individual with disabilities to perform the essential functions. Position requires prolonged standing, walking, and sitting. Requires frequent bending, stooping, or stretching; May require lifting up to 20 pounds. Position requires eye-hand coordination, and manual dexterity. Requires normal vision range, and color perception.