Refund Specialist - Insurance
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).
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 collaborated 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 a related field, or an equivalent combination of education, training, and experience
- Minimum of 3 years of experience in a healthcare or managed care environment, preferably within a large physician practice
- At least 1 year of experience handling complex insurance refunds
- Strong knowledge of physician reimbursement methodologies and managed care claim payment processes
- Advanced proficiency in Microsoft Excel and financial analysis related to physician reimbursement
- Strong analytical skills with exceptional attention to detail
- Ability to provide clear, professional verbal feedback
- Ability to follow and understand instructions and respond appropriately in various work situations
- Demonstrates mental adaptability and flexibility when working with diverse individuals and changing priorities
Note: 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 to $23.00. 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
SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.