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Medical Reimbursement Refund Specialist
Location:
Jacksonville, FL
Description:
Nemours is seeking a Medical Reimbursement Refund Specialist (Full-Time), to join our team in Jacksonville, Florida. The primary function of a Medical Reimbursement Refund Specialist is to reconcile and resolve credit balances. This includes credit balances in the insurance, self-pay, and undistributed work queues. Accounts are resolved through the correct application of payments, and adjustments or the issuing of refund checks to guarantors or third-party payers. It is the responsibility of the Medical Reimbursement Refund Specialist to research and resolve the credits by following established protocol and notation in the Epic System with the appropriate codes and narrative notes. Job Responsibilities * Research government, commercial and self-pay credits per contractual, CMS and/or state rules to maintain compliance. Prepares/submits documentation as required for overpayment recovery. Handles correspondence received from payors related to credits, refund requests and posts payment audits in a timely manner. * Responsible for reconciliation, adjudication and processing of all refunds using in-depth knowledge of contractual arrangements and in-depth knowledge of COB and subrogation rules. * Thorough understanding and interpretation of contracts for inpatient and outpatient in order to correct errors in the calculation and posting of insurance contractual adjustments. * Works with patients, payors, auditors, Payor Contracting and other Patient Accounting teams to resolve credit and refund request issues - using knowledge, experience, critical thinking skills & all tools to protect Nemours assets. * Documents any request or concern received via mail, e-mail, telephone, written correspondence on the patient's account. * Report any trends, i.e., payor consistently not paying according to contract, to Supervisor. * Maintain production and accuracy to meet at least the minimums established for the department. * Assists with audits to ensure necessary preparation is complete and help prevent fines for non-compliance. * Other duties as assigned. Job Requirements * High School Diploma required. * Minimum six (6) months of experience required.
Company:
Nemours
Posted:
June 13 on Equest
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More About this Listing: Medical Reimbursement Refund Specialist
Medical Reimbursement Refund Specialist is a Jobs Medical Reimbursement Refund Job at Nemours located in Jacksonville FL. Find other listings like Medical Reimbursement Refund Specialist by searching Oodle for Jobs Medical Reimbursement Refund Jobs.
Medical Reimbursement Refund Specialist is a Jobs Medical Reimbursement Refund Job at Nemours located in Jacksonville FL. Find other listings like Medical Reimbursement Refund Specialist by searching Oodle for Jobs Medical Reimbursement Refund Jobs.