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PATIENT REP IV-REFUND

Methodist Hospitals

Merrillville, Indiana

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JOB DETAILS
SKILLS
Analysis Skills, Billing, Business Practices, Calculators, Claims Processing, Co-Payments, Communication Skills, Computer Skills, Contract Management, Corporate Compliance, Credit Analysis, Credit and Collections, Documentation, Establish Priorities, Federal Laws and Regulations, Finance, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, Healthcare Providers, High School Diploma, Hospital, Insurance, Investigative Reports, Mathematics, Medicaid, Medical Billing, Medical Office, Medical Records, Medicare, Organizational Skills, Presentation/Verbal Skills, Procedure Development, Regulations, State Laws and Regulations, Telephone Skills, Trend Analysis, Typing, Writing Skills
LOCATION
Merrillville, Indiana
POSTED
16 days ago
Overview: Accurately review and process all third party payor, collection agency, patient, and other payments. Review the accuracy of credit balance status and prepare the necessary documentation for refunds. Responsibilities: PRINCIPAL DUTIES AND RESPONSIBILITIES(*Essential Functions)
  1. Reviews work-queues for credit balances and determines resolution.
  2. Reports Medicare Credits to the Medicare Collection Associate for claim adjusting and files Quarterly report to Medicare.
  3. Research and prepare refund requests and adjustments to correct account balances.
  4. Process refunds/adjustments to the appropriate unit or clinic and reoccurring accounts.
  5. Codes accounts for unit billing payments, deductibles, coinsurance, co-pay, etc., for contract management system.
  6. Responds to customer phone calls regarding requests for refunds.
  7. Identifies and notifies Finance of unclaimed property to be turned over to the State.
  8. Reviews, logs and reports on Medicaid Audits for possible billing to other payers.
Qualifications: JOB SPECIFICATIONS(Minimum Requirements)

  • KNOWLEDGE, SKILLS, AND ABILITIES
  • Accuracy rate of 95% must be maintained.
  • Productivity requirement of 8.67 accounts per hour must be met.
  • Insurance Audit Requests must be logged, investigated, and findings reported within timeline requirement.
  • New credit balances reviewed each day to ensure accurate cash posting to account.
  • Trends of credits need to be reported in order to find a resolution.
  • Agencies must be contacted to ensure all debts are settled before refunding.
  • Knowledge of UB-92 and 1500 billing preferred.
  • Must have working knowledge of insurance claim filing, collections, and established refund processing procedures.
  • Ability to prioritize job functions, work independently and exercise good judgment.
  • Must possess good written and verbal communication skills.
  • Must possess good organizational/analytical skills and mathematical aptitude.
  • Proficient use of calculator and minimum typing (55 wpm).
  • Basic personal computer skills.

EDUCATION
  • High School Diploma/GED Equivalent General Studies Required
  • Associates Business Preferred
  • 6 Healthcare/Medical - Business Office Required

STANDARDS OF BEHAVIOR
Meets the Standards of Behavior as outlined in Personnel Policy and Procedure #1, Employee Relations Code.

CONFIDENTIALITY/HIPAA/CORPORATE COMPLIANCE
Demonstrates knowledge of procedures for protecting and maintaining security, confidentiality and integrity of employee, patient, family, organizational and other medical information. Understands and supports the commitment of Methodist Hospitals in adhering to federal, state and local laws, rules and regulations governing ethical business practices for healthcare providers.

DISCLAIMER - The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. The statements are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required.

About the Company

M

Methodist Hospitals

A recognized leader in Lake County, Methodist offers specialized staff, comprehensive services and technically advanced equipment and facilities. This leadership is a reflection of our commitment to optimize the health and well being of our communities.

We continue to add to our team individuals who are dedicated, motivated, highly skilled, and willing to bring their hearts to share with those we serve.

Additionally, we offer competitive compensation packages and benefits. Our benefits package includes medical, dental and vision insurance coverage. We also provide tuition reimbursement, life insurance and 401k with a fixed hospital contribution, plus a 50% matching contribution. Time away from the hospital is awarded through our Paid Time Off (PTO) benefit plan.

Come and join our team of dedicated professionals here at The Methodist Hospitals. Our continued goal is to deliver excellent healthcare while providing a work environment that is second to none. Excellent career opportunities await you at Methodist Hospitals.

INDUSTRY
Healthcare Services
FOUNDED
2013
WEBSITE
http://www.methodisthospitals.org/

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