POSITION SUMMARY:
The Patient Refunds Specialist is responsible for managing and processing patient refunds within a healthcare setting. This position requires a strong understanding of healthcare billing practices, insurance processes, and patient payment systems. The specialist ensures that patient refunds are processed accurately and efficiently in compliance with clinic policies and regulations, ensuring patients receive prompt reimbursements for overpayments or billing errors.
ESSENTIAL DUTIES: - Review patient accounts to identify overpayments or billing discrepancies that require refunds.
- Ensure refunds are processed in a timely manner according to clinic policy.
- Verify and document patient account details before issuing refunds and patient payments
- Contact patients to inform them of upcoming refunds or request additional information as necessary.
- Answer patient inquiries regarding refunds.
- Provide clear and accurate explanations of refund procedures, including timelines and methods of reimbursement.
- Reconcile patient accounts to ensure that all refunded amounts are appropriately documented and reflected in the system.
- Investigate and resolve discrepancies in patient accounts.
- Ensure compliance with all relevant healthcare billing regulations, including HIPAA, payer policies, and clinic protocols.
- Maintain detailed and accurate records of all refund transactions.
- Prepare reports related to patient refunds for review by management, ensuring transparency and audit-readiness.
- Keep up to date with changes in billing practices, insurance policies, and healthcare regulations to ensure refund processes remain compliant.
- Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations.
- Other duties as assigned.
POSITION REQUIREMENTS:
A.KNOWLEDGE, SKILLS AND ABILITIES:
- Strong knowledge if healthcare insurance plans, billing procedures; and refund processes.
- Strong written and verbal communication skills.
- Ability to handle sensitive patient information with confidentiality and professionalism.
- Strong problem-solving skills.
- Ability to work independently with minimal supervision and as part of a collaborative team.
- Ability to prioritize tasks and manage time effectively in a fast-paced environment.
- Attention to detail and accuracy required.
- Dependability
QUALIFICATIONS:
B. EDUCATION, EXPERIENCE AND SKILLS REQUIRED:
- High School Diploma or equivalent. Associate’s degree in healthcare administration, billing, or related field preferred
- Minimum of 2 years’ experience in medical billing, or healthcare and administrative medical office setting, with a focus on refunds preferred
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