Refunds Processing Rep I jobs in United States
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Aurora Health Care · 21 hours ago

Refunds Processing Rep I

Aurora Health Care is a healthcare organization seeking a Refunds Processing Rep I to analyze and resolve credit balances and requests for refunds. The role involves utilizing multiple systems to ensure proper reimbursement calculations and documenting actions taken to resolve credit or refund requests.

Health Care

Responsibilities

Responsible for analyzing and resolving credit balances and requests for refunds within all AAH Hospital Billing entities and Professional Billing within multiple patient accounting systems and ensure appropriate contract reimbursement calculation rates are applied
Utilize multiple systems to review credit balances as assigned to determine the appropriate course of action needed to accurately resolve
Determine payor creating overpayment credit, verify coordination of benefits, reimbursement calculations and payment source and follow the appropriate system process and department procedures to resolve
Identify and report root cause of credit balances and payer refund trends; partner with internal and external counterparts
Document patient account notes and Guarantor account notes with all actions taken to resolve credit or refund requests
Possess knowledge of the Refund/Adjustment processes and utilizes systems/applications proficiently in order to resolve credit balances and process refunds appropriately. Contribute to improvement initiatives and department/system goals
Adheres to established Advocate Aurora Health Revenue Cycle policies, procedures, guidelines and productivity standards and responsible for maintaining personal growth and development
Responsible to read and understand all AAH Revenue Cycle policies and departmental policies and procedures
Assists level II's in completing ad hoc projects and related job activities as assigned to support department operations. During periods of high volume and/or impending deadlines, assignments may include assisting with patient accounting activities and functions typically performed by other Revenue Cycle positions
Acquires and maintains knowledge of all healthcare and insurance regulations, local, state, and federal legislation and regulatory agencies and activities which may affect Revenue Cycle operations

Qualification

Patient accounting systemsHealthcare regulations knowledgeMicrosoft OfficeBookkeeping skillsEthical conductOrganizational skillsCommunication skillsAttention to detailWork independently

Required

High School Graduate
Typically requires 1 year of experience in healthcare business office setting
Good organizational ability and communication skills (written and verbal)
Ability to read, enter and retrieve information from multiple patient accounting systems
Basic understanding of Microsoft Office
Basic bookkeeping skills and a strong mathematics aptitude
Able to work independently, under pressure in a fast paced environment
Strong attention to detail and maintains high degree of accuracy
Managed Care payer contract terms and Medicare/Medicaid payer guidelines
Ethical conduct
Regular and reliable attendance
Must be able to sit the majority of the workday
Exposed to a normal office environment
Operates all equipment necessary to perform the job

Company

Aurora Health Care

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At Aurora Health Care, helping people live well is what drives us – it’s our purpose and what we do every day.

Funding

Current Stage
Late Stage

Leadership Team

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Kristie Geil DNP, RN, CENP
Area VP/CNO Aurora Health Care, South Wisconsin, VP/CNO Aurora Medical Center Kenosha
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Carla LaFever
Chief Clinical Services Officer
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Company data provided by crunchbase