Reports to
Revenue Cycle Supervisor

 Summary/Objective
This employee is responsible for researching and resolving all patient and insurance credit balances and requests for refunds in a timely manner as well as reconciling payments and posting any outstanding payments or credits. 

Essential Functions

· Investigate insurance refund requests received via mail and take appropriate action.

· Investigate self-pay credit balances based on reporting and take appropriate action, including reallocation to open balances.

· Investigate insurance credit balances based on reporting and take appropriate action.

· Analyze all accounts for the legitimacy of the refund and rectify false credits on accounts.

· Works with the customer experience specialist to process refunds prompted by patient phone calls.

· Resolve unapplied cash on account in system.

· Process mail returns on refund checks.

· Report to RCM team on completed, pending, or outstanding refunds as needed.

· Other duties as assigned by supervisor.

Competencies

· Requires well-developed organizational skills and basic office operations to assure appropriate documentation and follow-through to meet the patient and department needs.

· Demonstrates a patient-focused attitude - committed to providing excellent service to all patients, staff, and visitors. 

· Willingness to assist with genuine interest in the well-being of others.

· Must demonstrate ability to work in fast-paced, deadline-oriented environment where the ability to meet deadlines is a must with constant communication required.

· Demonstrates proficient computer skills including accurate data entry into Microsoft Excel, as well as documentation and communication through Microsoft Outlook and various EMRs.

Supervisory Responsibility

None

Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Physical Demands

The employee is occasionally required to stand; walk; sit; and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds.

Position Type/Expected Hours of Work
Full Time / Monday – Friday

Travel

None

Work Authorization/Security Clearance

Must be authorized to work in the US for any employer

AAP/EEO Statement

US Digestive Health is an Equal Opportunity Employer. USDH does not discriminate based on race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status, or any other basis covered by appropriate law. All employment is decided based on qualifications, merit, and business need

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

High School Diploma or equivalent

Minimum 3-5 years of experience in refunds processing preferred but not required.