Community Health Systems Lead Refunds Specialist in Tucson, Arizona
Processes refunds to patient accounts and prepares daily credit balance reports, using computer systems, databases and ledgers. Responsible for Web based discrepancy refunds and RN lines to logging system. Assists manager with month end reporting. Is flexible in work priorities and performs other duties as assigned. Serves as lead for the refunds team and participates in training of new staff.
ESSENTIAL JOB FUNCTIONS :
Processes refunds to patient accounts, maintaining appropriate knowledge and understanding of all Managed Care Contracts and Federal payors. Work overpayments request for refund letters, faxes and telephone requests.
Utilizes computer systems and databases.
Prepares daily Credit Balance reports. Analyzes issues causing credit balances. Corrects contractual adjustment amount ifneeded. Compiles refund request with appropriate documentation.
Performs the quarterly Medicare Credit Balance review and Escheat Report. Pulls EOB's and required documentation to accurately prepare refunds for processing.
Ensures compliance procedure for prompt recording of all refunds.
Coordinates any refund issues with Reimbursement Manager/Supervisor and Reimbursement Specialists as needed.
Sets priorities to meet departmental needs.
Completes productivity reports weekly, monthly as required timely.
Balance and clear the withholding GL s for all SSC supported hospitals.
Clear the Insurance Unapplied accounts for 8 hospitals.
Facilitate and organize all audits and projects.
Answer questions via e-mail from the Facilities, TSSC Customer Service and PASI regarding credits, refunds, offsets, GL s and account discrepancies. These are not limited to my 4 assigned Facilities.
Review all offsets submitted by the Collectors for all 12 hospitals to determine if the money is in the Withholding or needs to be posted by the posting staff.
Review all negative/offset remits from the Correspondence for all 12 hospitals for the posting staff.
Answer any training/refund questions presented by my 3 trainees and 2 seasoned Refund Representatives.
Write step actions for various refund procedures, adjustment sheet and payment transfer procedures.
Process all Patient Balance Transfer forms for all hospitals.
Takes sense of ownership regarding other related duties as assigned.
EDUCATION, SKILLS & EXPERIENCE:
High School graduate or equivalent
o Three (3) years accounts receivableexperience in hospital or medical setting. Two (2) year experience working withManaged Care Contracts and Federal programs, and two (2) years working withrefunds.
- Administrative Skills:
o Excellent interpersonal skills required to communicate with direct staff and internal/external customers.
o Must possess excellent time management and organizational skills.
o Demonstrated critical thinking,creativity, problem solving and decision-making skills.
Job: Business Office
Organization: Shared Services Center - Tucson
Requisition ID: 1814378