Refund Proc Rep I
Please mention DailyRemote when applying
AI Summary
Department:
Status:
Benefits Eligible:
Hours Per Week:
Schedule Details/Additional Information:
Remote M-F
Pay Range:
$22.90 - $34.35Major Responsibilities:
Facilitate the reduction of credit balances and refund requests within Advocate Health Hospital Billing and Professional Billing entities, ensuring appropriate contract reimbursement rates are applied. Focus on highly complex accounts as needed.
Review and research requests via multiple systems, electronic inboxes, mail, work queues, legacy system reports, vendor, audit, and compliance projects within the appropriate time frame.
Conduct high-level analysis of other team members' transactions before releasing to payee, including escalated requests, using sound decision-making skills.
Determine the payor responsible for overpayment, verify coordination of benefits, reimbursement calculations, and payment sources, and follow system processes and department procedures to resolve.
Identify and report root causes of credit balances and payer refund trends; partner with internal and external counterparts.
Document patient and guarantor account notes with all actions taken to resolve credit or refund requests.
Demonstrate extensive knowledge of refund/adjustment processes and utilize systems/applications proficiently to resolve credit balances and process refunds.
Drive improvement initiatives within daily work, collaborate with peers as a resource, and encourage engagement to positively impact department and system goals.
Work with the Revenue Cycle Process Designer as needed to update or draft workflow updates.
Oversee ad hoc high-level projects independently and related job activities as assigned to support department operations. Assist with patient accounting activities during high volume periods or impending deadlines.
Consistently exceed quality assurance and productivity standards.
Licensure, Registration, and/or Certification Required:
None Required.
Education Required:
High School Graduate
Experience Required:
Typically requires 3 years of experience in healthcare business setting.
Knowledge, Skills & Abilities Required:
Strong organizational ability and communication skills (written and verbal).
Expert ability to read, enter and retrieve information from multiple patient accounting systems.
Proficient understanding of Microsoft Office
Bookkeeping skills and a strong mathematics aptitude.
Strong ability to work independently, under pressure in a fast paced environment.
Pay strong attention to detail and maintains high degree of accuracy.
Strong Managed Care payer contract terms and Medicare/Medicaid payer guidelines.
Ethical conduct.
Regular and reliable attendance.
Physical Requirements and Working Conditions:
Lifting 10 pounds or more for mailing.
Sitting for extended periods of time.
DISCLAIMER
All responsibilities and requirements are subject to possible modification to reasonably accommodate individuals with disabilities.
This job description in no way states or implies that these are the only responsibilities to be performed by an employee occupying this job or position. Employees must follow any other job-related instructions and perform any other job-related duties requested by their leaders.
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
Compensation
Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance
Benefits and more
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
Automatically Apply to the Best Remote Jobs
Stop the endless job search. Our AI finds and applies to the best jobs for you.
