EHPB Refund Specialist
1 year previous experience in professional billing.
Investigates credit balances, determining appropriate action and providing resolution. Processes all Healthplan requests for refunds and refunds due based on audits.
1. Investigates self pay and insurance credit balance encounters and takes appropriate action for resolution.
2. Investigates insurance overpayment /offset correspondence and takes appropriate action for resolution.
3. Handles patient phone inquiries regarding refunds.
4. Process refunds due from coding audits.
5. Mails refund checks attaching appropriate back-up documentation.
6. Process mail returns on refund checks.
7. Process Unclaimed Property credits.
8. Performs other duties as assigned.
License, Certification, Education or Experience:
REQUIRED for the position:
● High School graduate or equivalent.
● 1 year previous experience in professional billing.
● Knowledge and experience in working with health care insurers’ and their reimbursement systems , especially Medicare,
Medicaid, Workers Compensation, Motor Vehicle and contract payers.
● A good understanding of CPT, Modifiers, HCPC, ICD-9 codes and medical terminologies.
● Demonstrated problem solving ability.
● Ten-key by touch
DESIRED for the position:
● College degree/Vocational training in billing or business