Refunds Specialist Team Lead
Greater Atlanta Area
Work closely and communicate effectively with 15 staff members to insurance companies, government payers, hospital staff, physicians, patients and others to ensure timely billing and resolution of patient accounts, Medicaid billing. Performs interpretation, transaction posting and validation of payment information from third party batches in the form of images via an electronic posting system or hard copy paper correspondence. Interprets and post denial transaction codes as defined by the payer and provider organization to ensure the timely and accurate routing of denial follow-up and appeal activities. Processing of credit card payments and insurance payments with batch settlement procedures using tools such as credit card machines and web based payments sites. Performs research on a routine basis to determine the appropriate posting account for unidentified payments received by the third party payer remittance. Collaborates with multiple Revenue Cycle departments to investigate the location of a stated missing payment. Conducts scanning and indexing functions in conjunction with document storing and balancing procedures.Responsible for effective resolution of patients accounts with insurance companies (e.g. third party, government, HMO PPO and Commercial payers). Thoroughly analyze remittance accounts to ensure payment and required contractual allowances are applied/properly. Identify and report denial trends affecting reimbursement Handled inbound patient collection calls as assigned in a professional and courteous manner, processing refunds. Follow all Business Standards for processes and documentation for the Account Receivable Department. Research credit balances for entire enterprise, determining if credit balances are due back to payer (patient, insurance or government payer). Use internet tools for EOB retrieval, If a refund is not in order, process credit balance in accordance with recovery procedures.
