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Refund/Overprovisions Rep in Knoxville, TN - Maryville, TN - Alcoa, TN at TeamHealth

Date Posted: 9/14/2018

Job Snapshot

Job Description

JOB DESCRIPTION OVERVIEW:

This position is responsible for processing refunds, recoups, adjustments and unidentified payments for Anesthesia groups. Maintains accuracy and production.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Processes guarantor, Medicare, Medicaid, Champus, Federal, and specific other situations for all groups to determine who is to be refunded;
  • Reviews and works all credit reports assigned within compliance guidelines;
  • Assembles appropriate documentation to validate refunds and forward to senior for approval;
  • Handles telephone inquiries regarding overprovisions;
  • Handles correspondence related to credit balances according to written procedures;
  • Contacts insurance carriers/guarantors as necessary on credit balances, offsets and unidentified payments;
  • Maintains completion of sign off logs reflecting monthly goals are being met to stay within compliance guidelines;
  • Reports any consistent errors identified that affect accounts from being processed correctly;
  • Research unidentified payments and offsets to determine the appropriate application of payments identified;
  • Responsible for maintaining all policy and procedures;
  • Turns to Supervisor for unusual circumstances that may include refunds, offsets, unidentified, etc;
  • Performs all duties as directed by management.

Job Requirements

QUALIFICATIONS / EXPERIENCE:

  • High school diploma or equivalent required;
  • Previous medical billing experience preferred;
  • Excellent communication skills both oral and written;
  • Good computer skills;
  • Ability to meet deadlines;
  • Regular and predictable onsite attendance;
  • High level of interaction and teamwork.

SUPERVISORY RESPONSIBILITIES:

  • None

PHYSICAL / ENVIRONMENTAL DEMANDS:

This job is performed in a well-lighted and well-vented environment. Work is oriented around good visual skills. Eye fatigue may be encountered as extended amount of time is spent in front of computer display terminal.

This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, 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.