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Medical Refund Specialist
- Emerus Holdings Inc
- Shift Type
Emerus, the nation’s first and largest operator of micro-hospitals, has incorporated a new paradigm into patient care that has significantly improved access to health care for thousands of people, many of whom live in underserved areas where high-quality patient-centric acute episodic and ambulatory clinical services are needed most. Focusing on excellence, empathy and innovation, Emerus hospitals are organized around the patient and family. This concept allows Emerus and its partners to work with patients while they are healthy to keep them healthy, providing a level of compassionate care and support typically not found at larger hospitals, free-standing emergency rooms or urgent care centers. Emerus works with leading health systems across the nation, including Dignity Health, Baptist Health, The Hospitals of Providence, Alleghany Health Network, INTEGRIS and Baylor Scott & White Health, to put more care and best-in-class provider services into the communities they serve. The Emerus corporate office is based in The Woodlands, Texas, north of the thriving metropolis of Houston. More information is available at emerus.com.
The purpose of this position is to assist in managing the company’s outstanding credit balances and to ensure that all balances are correct and refund requests are processed accurately and timely.
Essential Job Functions
- Review all documents submitted for refund processing for accuracy.
- Reviews patient account to ensure refund request is appropriate and verifies no additional outstanding balances.
- Ensure that submitted forms are completed and accurate.
- Ensure changes to account balance have not been made from time of request to time of processing.
- Accurately note accounts with processing updates.
- Accurately and timely post refunds to patient accounts.
- Prepare checks for mailing to patients/payers.
- Properly document account once refund has been posted
- With the assistance of Accounts Payable, identifies and researches uncashed refund checks and contacts payers or patients if necessary
- Works special projects as assigned by Supervisor/Director/CFO
Other Job Functions
- Meet position’s goals and objectives related to accuracy
- Attend staff meetings or other company sponsored or mandated meetings as required
- Perform additional duties as assigned
- High School Diploma or GED, required
- 2+ years experience in a health care setting, required
- Knowledge of all payers insurance; self-pay after insurance, reimbursements, collections, appeals, claims follow-up and third party billing, required
- Experience with medical records or patient accounting systems, required
- Knowledge and understanding of healthcare ‘explanation of benefits’ (EOB’s), required
- Excellent attention to detail
- Proficient in Microsoft Office
Position requires fluency in English; written and oral communication