Refund Specialist: Insurance Claims
Job Posting for Refund Specialist: Insurance Claims at Compri Consulting
Compri Consulting is hiring a Refund Specialist: Insurance Claims for a 6-month contract opportunity with our client located in Washington. Hybrid and remote positions available.
Description
Our Client is looking for a Refund Specialist for the Credits Team in Revenue Operations Department. In this position, you will analyze EOBs and/ or payor correspondence to reconcile system credit balances or potential overpayments, research and resolve problem accounts, and request adjustments. You will effectively identify trends and analyze root causes to drive work efficiently within the team. All necessary equipment is provided.
Required Skills
Description
Our Client is looking for a Refund Specialist for the Credits Team in Revenue Operations Department. In this position, you will analyze EOBs and/ or payor correspondence to reconcile system credit balances or potential overpayments, research and resolve problem accounts, and request adjustments. You will effectively identify trends and analyze root causes to drive work efficiently within the team. All necessary equipment is provided.
Required Skills
- Autonomously research, initiate follow-up and resolve all health care insurance claim accounts with existing credit balances (claim(s) paid more than expected by payer); actions included but not limited to initiating refund packets, retractions, and/or adjustments to claims
- Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution of claims
- Use critical thinking, root cause analysis, and problem solving skills to resolve issues on outstanding claim balances
- Uses strong organizational skills to effectively manage large amounts of detailed information
- Utilizes excellent written and oral communication skills to collaborate and maintain positive working relationships with peers, leaders, clinical personnel, and payer representatives to resolve credit balances.
- Contributes to implementation of process improvement initiatives aimed at improving credit department
- Ensures compliance by using established internal control procedures by examining records, reports, operating practices, and documentation
- Stay current on communications relating to healthcare reimbursement and regulatory changes
- Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies
- Understand and adhere to all policies, laws and regulations applicable to this role
- Consistent, regular, punctual attendance as scheduled is an essential responsibility of this position
- Participate in group settings and team work environment
- High School Diploma or equivalent required
- Healthcare and medical claim overpayment remediation and refunding experience is required
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