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Medical Billing Refunds Representative, HM in Louisville, Tennessee at TeamHealth

Date Posted: 6/3/2023

Job Snapshot

Job Description

Join a team of dynamic, results oriented professionals!

Named among “The World’s Most Admired Companies" by Fortune Magazine
Named among "America's 100 Most Trustworthy Companies" by Forbes magazine
Named among “Great Places to Work" by Becker’s Hospital Review

  • Career Growth Opportunities
  • Convenience market on site
  • Benefit Eligibility (Medical/Dental/Vision/Life) the first of the month following 30 days of employment
  • 401K program (Discretionary matching funds available)
  • Employee Assistance Program
  • Referral Program
  • Dental plans & Vision plans
  • GENEROUS Personal time off
  • Eight Paid Holidays per year
  • Quarterly incentive plans
  • Business casual dress code
  • Employee of the month awards with monetary gift and parking space
  • Training Programs
  • Fitness Center with personal trainer on site
  • Wellness programs
  • Flexible work schedule

 

JOB DESCRIPTION OVERVIEW:

This position is responsible for processing patient invoices with credit balances, recoups, adjustments and unidentified payments for Hospitalist and Clinic groups. Maintains accuracy and production.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Review guarantor, government payers, and commercial insurance overpayments for all groups to determine who is to be refunded.
  • Create a manual task for the invoice that has the overpayment.
  • Processes invoices in assigned worklist and strives to maintain view age at 30 days or less. This includes reviewing all the previous actions applied to determine how to proceed, entering task note to reflect current action and an outcome to recap the action performed.
  • Assembles appropriate documentation to validate refunds and forward to senior for approval.
  • Handles telephone inquiries regarding overprovisions.
  • Processes correspondence related to credit balances according to written procedures.
  • Processes transfer of payment and cancelled check research forms.
  • Contacts insurance carriers/guarantors as necessary on credit balances, offsets, and unidentified payments.
  • Reports any error trends identified that affects accounts from being processed correctly.
  • Participates in team meetings with Overprovision Supervisor regarding ETM PIT Report, Weekly Credit Report, and the Government Overprovisions 120+ Report.
  • Research unidentified invoices and reports to determine the appropriate application of payments identified.
  • Turns to Senior or Supervisor for unusual circumstances that may include refunds, offsets, unidentified, etc.
  • Performs any duties as directed by Management

 

Job Requirements

QUALIFICATIONS / EXPERIENCE:

  • High School diploma or equivalent
  • Exceptional organizational skills and a high accuracy performance
  • Must be able to work independently and in a close team environment
  • Minimum one year of experience in medical billing, excellent communication skills, and ability to meet deadlines and production goals and good computer skills are required.

 

PHYSICAL / ENVIRONMENTAL DEMANDS:

  • Job performed in a well-lighted, modern office setting
  • Occasional standing/bending
  • Moderate stress
  • Prolonged sitting
  • Prolonged work on a computer

 

This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, and fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions. Also, may require physical and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.

 

DISCLAIMER:

Cooperative, positive, courteous and professional behavior and conduct is an essential function of every position. All employees must be able to work with others beyond giving and receiving instructions. This includes getting along with co-workers, peers and management without exhibiting behavior extremes. Job functions may require personal leadership skills such as conflict resolution, negotiating, instructing, persuading, speaking with others as well as responding appropriately to job performance feedback from the supervisor. Additionally, the information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position.