Revenue Cycle Refund Specialist Job at SEES Group, LLC
SEES Group operates multi-specialty medical practices and ambulatory surgery centers across the Southeastern United States and US Territories. Working with community-based Optometrists and Physicians, we provide patients with the highest quality medical and surgical eye care they need close to home. Our organization’s shared values include integrity, respect, service, compassion, and excellence!
SEES Group recognizes that our employees are our most important asset. Because of this, we strive continuously to encourage our staff to live their healthiest life by providing benefits, perks, resources, and programs to assist with managing both their physical and mental health. We offer access to an employee assistance program for those who may need mental health, legal, or financial assistance. Additional resources and programs revolving around health and wellness are offered through our benefit providers. We publish quarterly company newsletters on rotating wellness topics and challenges for our staff members. Also, we are currently offering a quarterly “Stress Free Day” to full time staff members where employees can take a paid day off to focus on their own wellness and mental health.
Aside from those fantastic benefits, we also offer medical, dental, and vision insurance; 7 paid holidays; employer paid life Insurance; a robust paid-time allotment; voluntary products such as short and long term disability coverage; and a 401k retirement plan with a generous employer match. We offer certification programs to clinical staff to assist in professional development. Lastly, we offer employee service awards to our tenured staff members to recognize our appreciation for their continued service to our organization.
POSITION SUMMARY
The Refunds and Financial Advisor Specialist is responsible for all facets of coordination of refunds to patients and payers across the enterprise. The primary duties include but are not limited to verification of credit balances on patient accounts, research to ensure other patient balances are not due and owing to other Company entities, transfer of credit balance among or between Company entities when applicable, and processing refunds involved in cases that are co-managed by outside optometrists. Additionally, the Refunds and Financial Advisor Specialist will be familiar with all financial assistance and payment arrangement options offered by SEES Management, LLC and will be responsible for gathering application information from patients who require such assistance and either approving requests for financial assistance based upon established criteria or escalating these requests to the appropriate Manager. Refunds and Financial Advisor Specialists shall be responsible for producing monthly reports showing activities and outcomes so that trends may be monitored appropriately. In addition, Refunds and Financial Advisor shall be cross-trained in other functions of revenue cycle responsibilities, including processing charges, posting payments, following up on unpaid balances (current and in collections), and answering patient questions regarding their balances.
ESSENTIAL FUNCTIONS include the following:
- Reviews and investigates monthly credit balance reports and determines if a refund is due to a patient or insurer
- Processes refunds to patients or insurers appropriately, or assists in the determination of when a credit balance transfer should occur between SEES Management, LLC entities
- Processes monthly co-management reports so that appropriate entries are made in patient accounting system prior to co-management payment being issue to external co-managing physicians.
- Provides reports to management regarding refund or credit balance activity to ensure accounting and compliance standards are met
- Research unidentified cash and returned checks for processing
- Identify Payment Posting/Processing Issues and communicate trends and findings.
- Processes, posts and credit balance payments when transferred between or among company entities
- Completes monthly escheat documentation and files Unclaimed Property Report with each state in which SEES Management, LLC is conducting business
- Review and processes applications for Financial Assistance according to approval guidelines
- Escalates Financial Assistance applications according to pre-defined criteria
- Provides monthly reports regarding Financial Assistance applications so that trends may be identified
- Troubleshoots and resolves issues with any of the patient billing processes within scope of job functions
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Familiarity with deductibles, contractual adjustment, insurance plans, and procedures
- Good problem solving and analytical skills
- Understanding of cash processing transactions, including payment and adjustment posting
- Understanding of remittances reason and remark codes
- Detail oriented with strong organizational and follow-up skills
- Strong interpersonal and customer service skills
- Strong computer skills
- Ability to adapt to changing insurance regulations
- Ability to discuss collections with patients in a confident manner
- Ability to speak, read, and write in English
- Ability to effectively communicate both orally and in writing
- Ability to operate standard office equipment
- Ability to concentrate, think, and learn
- Ability to hear, see, sit, stoop, kneel, crouch, reach, lift, push, and pull.
EDUCATION AND/OR EXPERIENCE
High School diploma or equivalent is required; a minimum of one (1) year experience in medical billing and collections or cash management in a healthcare setting is preferred; medical insurance knowledge is required; and/or equivalent education or experience in job related activities is required.
Candidates must reside in one of the following states: TN, AL, GA, FL, USVI
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