Refund Specialist

Refund Specialist (Preferred insurance overpayments and credit balances experience)

Remote - USA

Full time

R4960

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results.

We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

Job Summary

The Refund Specialist-Insurance is responsible for reviewing accounts, identifying insurance overpayments and credit balances. Evaluates and verifies refunds are issued in accordance with current policies and procedures.

Essential Duties & Responsibilities

• Reviews refund/overpayment requests from insurance payers to determine if an overpayment has occurred.

• Reviews and resolve credit balances through credit transfers, account corrections and refund request form completion for manual refund check requests.

• Identifies root causes and trends contributing to patient and insurance credit balances and works collaboratively with all areas of the revenue cycle to improve efficiency and eliminate these issues.

• Posts debits for approved refunds.

• Research returned checks and collaborates with A/P for reporting to unclaimed property.

• Resolves Department credit balance inquiries for transfers and refund check requests.

• Ability to work collaboratively and build positive business relationships with clinical areas and the payer community.

• Understanding of electronic medical record / billing system Pricing Module and fee schedules

• Develops expertise with payer specialty-specific payment policies, by using the payer assigned websites.

• Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure

• Perform other related duties as required

Minimum Requirements & Competencies

• Bachelor’s degree in accounting, business, finance or an equivalent combination of training and experience

• 3 years’ experience in health care/managed care environment, preferably in a large physician practice or a combination of experience and education.

• 1 year of experience with complex refunds to insurance

• Knowledgeable in physician reimbursement and managed care claim payment issues.

• Excellent communication skills and ability to effectively communicate with various levels of management in a multi-disciplinary environment.

• Strong analytical skills with attention to detail.

• Advanced level with Excel and financial analysis related to physician reimbursement

• Travel: Minimal

Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations.

The salary range for this role is from $21.00 - $24.00 per hour.

However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills.