Refund Specialist: Insurance Claims
Job Title: Refund Specialist: Insurance Claims
Location: Federal Way, WA HYBRID ONSITE
Duration: 4+ months
Job Description :
RESPONSIBILITIES:
Autonomously research, initiate follow-up and resolve all health care insurance claim accounts with existing credit balances (claim(s) paid more than expected by payer); actions included but not limited to initiating refund packets, retractions, and/or adjustments to claims
Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution of claims
Use critical thinking, root cause analysis, and problem solving skills to resolve issues on outstanding claim balances
Uses strong organizational skills to effectively manage large amounts of detailed information
Utilizes excellent written and oral communication skills to collaborate and maintain positive working relationships with peers, leaders, clinical personnel, and payer representatives to resolve credit balances.
Contributes to implementation of process improvement initiatives aimed at improving credit department
Ensures compliance by using established internal control procedures by examining records, reports, operating practices, and documentation
Stay current on communications relating to healthcare reimbursement and regulatory changes
Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies
Understand and adhere to all policies, laws and regulations applicable to this role
Consistent, regular, punctual attendance as scheduled is an essential responsibility of this position
Participate in group settings and team work environment
Qualifications:
High School Diploma or equivalent required
Healthcare and medical claim overpayment remediation and refunding experience is required
2-4+ years' experience with accounting, transactions, or medical billing/accounting systems required
Knowledge or experience working with a variety of health care insurance payers is preferred
Intermediate computer proficiency in Microsoft Office including Excel and Outlook- required.