Medical Refund Specialist 2.7 2.7 out of 5 stars 560 South Loop Road, Edgewood, KY 41017

General Job Summary:

Promotes the OrthoCincy mission to provide patients with premier orthopedic care while focusing on their individual needs. Responsible for all aspects of patient refunds and insurance reimbursement requests. •Option to work from home after training period is complete.

Essential Job Functions:

1. The ability to remain friendly and professional through communication with patients, providers, clinical staff, payers, and outside agencies through telephone, electronic, and written correspondence. Manages multiple work queues within the Credit Work Queue. Generate refund requests with the appropriate the documentation attached to support the refund. Post refunds within the practice management system and ensure accounts are balanced. Appropriate record keeping and management of documentation to support the refunds. Assist with self-pay patients, payment arrangement and online services. Collaborates with manager, coordinator, and director to report trends to ensure proper credit balance resolution. Experience with variety of billing issues involving payers (Medicare, Medicaid, private insurance, worker's compensation) including forms, coding compliance and reimbursement guidelines. Thorough knowledge of medical terminology, managed care financial agreements; CPT, HCPCS, and ICD-10 codes. Handle billing calls and answer incoming calls as needed. Demonstrates superior interpersonal relationship skills necessary for developing and maintaining positive professional relationships with patients, peers, providers, clinical departments, the management team, and payer organizations through telephone, electronic and written correspondence. Ensure compliance with all guidelines set by government programs, and OrthoCincy policies, such as federal regulations, HIPPA, and the No Surprises Act. Takes initiative in performing additional tasks that may be necessary or in the best interest of the practice.

Education/Experience:

High School Diploma or equivalent. Associate's Degree in Coding/Billing or minimum of two years medical billing experience is preferred. EPIC experience is preferred. Medical billing experience with an understanding of HCPCS, ICD-10 and medical terminology is preferred.

Other Requirements:

Must be customer service oriented with a team environment focus.

Schedules may change as department needs change, including overtime and weekends.

Performance Requirements:

Knowledge:

Knowledge and application of OrthoCincy's Mission, Vision and Values. Medical billing terminology required. CPT and ICD-10 coding knowledge preferred. Knowledge of medical billing/collection practices. Knowledge of medical terminology and anatomy. Knowledge of insurance filing and payment posting techniques. Knowledge of basic medical coding and third-party operating procedures and practices. Knowledge of electronic health records and practice management systems. Knowledge of current professional billing and reimbursement procedures preferred.

Other Requirements:

Must be customer service oriented with a team environment focus.

Schedules may change as department needs change, including overtime and weekends.

Skills:

Skilled in attention to detail. Skilled in organizing. Skilled in grammar, spelling, and punctuation. Skilled in communicating effectively with providers, staff, patients and vendors. Strong communication skills in a professional manner during stressful and sensitive situations with patients of all ages.

Abilities:

Ability to read and interpret Explanation of Benefits and patient account ledgers. Ability to problem-solve and the ability to interpret and make decisions based on established guidelines. Ability to work on a team while maintaining positive and professional relationships. Ability to multitask and handle stressful or difficult situations with professionalism. Ability to analyze situations and respond in a calm and professional manner.

Equipment Operated:

Standard office equipment.

Work Environment:

Medical office environment.

Mental/Physical Requirements:

Involves sitting and viewing a computer monitor approximately 90 percent of the day. Must be able to use appropriate body mechanics techniques when making necessary patient transfers and helping patients with walking, etc. Must be able to remain focused and attentive without distractions (i.e. personal devices). Must be able to lift up to 30 pounds.

Benefits:

401(k) 401(k) matching Dental insurance Employee assistance program Flexible spending account Health insurance Health savings account Life insurance Paid time off Professional development assistance Referral program Retirement plan Tuition reimbursement Vision insurance

Schedule:

8 hour shift Day shift Application Question(s): Have you ever been convicted of a felony or misdemeanor? If so, please explain. What is your salary expectation? Have you ever worked at OrthoCincy? If so, please list the dates.

Work Location:

In person