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Aurora Health Care · 1 day ago

Refund Proc Rep I

Milwaukee, WI

Full-time

Onsite

Entry Level

1+ years exp

Aurora Health Care is a healthcare organization seeking a Refund Processing Representative I. The role involves analyzing and resolving credit balances and refund requests within various patient accounting systems while ensuring compliance with contract reimbursement calculations and departmental policies.

Health Care

Responsibilities

Responsible for analyzing and resolving credit balances and requests for refunds within all AAH Hospital Billing entities and Professional Billing within multiple patient accounting systems and ensure appropriate contract reimbursement calculation rates are applied

Utilize multiple systems to review credit balances as assigned to determine the appropriate course of action needed to accurately resolve

Determine payor creating overpayment credit, verify coordination of benefits, reimbursement calculations and payment source and follow the appropriate system process and department procedures to resolve

Identify and report root cause of credit balances and payer refund trends; partner with internal and external counterparts

Document patient account notes and Guarantor account notes with all actions taken to resolve credit or refund requests

Possess knowledge of the Refund/Adjustment processes and utilizes systems/applications proficiently in order to resolve credit balances and process refunds appropriately. Contribute to improvement initiatives and department/system goals

Adheres to established Advocate Aurora Health Revenue Cycle policies, procedures, guidelines and productivity standards and responsible for maintaining personal growth and development

Responsible to read and understand all AAH Revenue Cycle policies and departmental policies and procedures

Assists level II's in completing ad hoc projects and related job activities as assigned to support department operations. During periods of high volume and/or impending deadlines, assignments may include assisting with patient accounting activities and functions typically performed by other Revenue Cycle positions

Acquires and maintains knowledge of all healthcare and insurance regulations, local, state, and federal legislation and regulatory agencies and activities which may affect Revenue Cycle operations

Qualification

Patient accounting systemsHealthcare regulations knowledgeMicrosoft OfficeBookkeeping skillsEthical conductOrganizational skillsCommunication skillsAttention to detailWork independently