What are the responsibilities and job description for the Refund Manager position at Ventra Health, Inc.?
Overview
Job Summary:
The Refund Manager is responsible for the for the daily operations of the Credit Balance & Refunds department.
Responsibilities
Essential Functions and Tasks:
Supervises and trains assigned staff, including 1-2 supervisors, ensures performance appraisals are conducted, makes employment and discipline recommendations, and coordinates work assignments.
Manages credit balance inventory to ensure credit balances and refund requests are resolved within expected turnaround times for both patient and insurance refund inventory.
Track trends to monitor opportunities for enhancements, innovative solutions, and continuous process improvements.
Tracks, maintains, and monitors employee metrics and ensures quality audits are completed timely and consistently.
Interacts with clients and Client Services teams by answering inquiries, providing credit balance reports, project updates, etc.
Participates in development and delivery of employee training courses and materials.
Qualifications
Education and Experience Qualifications:
Bachelor’s degree in Healthcare, Business, Finance, or similar is preferred. Experience can be substituted for education, or a combination thereof.
Four (4) years of revenue cycle experience, with emphasis in Cash Applications, AR, or Denials.
Four (4) years of experience working with commercial, government, and third party liability insurances; a strong working knowledge of payer adjustments and remark codes is required.
Two (2) years of direct experience with coordination of benefits, refunds, and Medicare reporting preferred.
Two (2) years of supervisory/management/leadership experience is required.
Experience with EMR optimization, systems enhancement, and/or Centricity Business is preferred.
Knowledge, Skills, and Abilities:
Experience processing electronic and manual payer EOBs, including the posting of insurance allowable, patient portions, denials, adjustments, and contractual allowances.
Strong working knowledge of department roles and responsibilities.
Ability to learn and work in multiple systems.
Strong supervisory/management skills.
Strong oral, written, and interpersonal communication skills.
Strong word processing, spreadsheet, database, and presentation software skills.
Strong financial analytics background.
Ability to draft SOPs and department policies.
Strong interpersonal skills.
Ability to read, understand, and apply state/federal laws, regulations, and policies.
Ability to remain flexible and work within a collaborative and fast paced environment.
Ability to communicate with diverse personalities in a tactful, mature, and professional manner.