Overprovisions Representative

TeamHealth is named among the Top 150 Places to Work in Healthcare by Becker's Hospital Review. Newsweek Magazine recognizes TeamHealth as ‘one of the greatest workplaces for diversity, 2024’ and TeamHealth is also ranked as ‘The World’s Most Admired Companies’ by Fortune Magazine. TeamHealth, an established healthcare organization is physician-led and patient focused. We continue to grow across the U.S. from our Clinicians to Corporate Employees. Join us.

What we Offer:
Career Growth Opportunities
Benefit Eligibility (Medical/Dental/Vision/Life) the first of the month following 30 days of employment
401K (Discretionary matching funds available)
Generous PTO
8 Paid Holidays
Equipment Provided for Remote Roles

JOB DESCRIPTION OVERVIEW:
This position is responsible for reviewing/processing GE reports and correspondence in ETM system related to credit balances, refund requests, recoups, payment research, and unidentified payments for Emergency service business line. As well as handling some customer service calls from insurance companies, patients and working with Fifth Third Bank. Maintains accuracy and production. The responsibilities of the position include, but are not limited to the following:

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Processes guarantor, Medicare, Medicaid, Champus, Federal, and specific other situations for all groups to determine who is to be refunded.
• Assembles appropriate documentation to validate refunds and forward to senior for approval.
• Handles customer service calls that are transferred from NPSC or Patient Services.
• Contacts insurance carriers/guarantors via phone call as necessary on credit balances, offsets, payment research invoices, mail correspondence, unidentified payments, and other reasons as needed.
• Handles correspondence related to credit balances according to written procedures.
• Processes transfer of payment.
• Researches cancelled checks to determine if a check has been endorsed and cashed but not posted to the patient’s account.
• Retrieves and processes NSF checks from the bank’s secured website.
• Reports any consistent errors identified that affect accounts from being processed correctly.
• Maintains knowledge of ETM system.
• Processes special projects as assigned by Management.
• Turns to supervisor or senior for unusual circumstances that may include refunds, offsets, unidentified, etc.
• Participates in department meetings.
• Other duties as assigned by Senior Representative, Overprovisions Supervisor and Patient Accounts Manager.

Job Requirements: