AR Refund Specialist - UofL Health

Overview

WE ARE HIRING!Location:250 E Liberty Street Louisville, KY 40202 

About UofL Health UofL Health is a fully integrated regional academic health system with nine hospitals, four medical centers, Brown Cancer Center, Eye Institute, nearly 200 physician practice locations, and more than 1,000 providers in Louisville and the surrounding counties, including southern Indiana. Additional access to UofL Health is provided through a partnership with Carroll County Memorial Hospital.  Affiliated with the University of Louisville School of Medicine, UofL Health is committed to providing patients with access to the most advanced care available. This includes clinical trials, collaboration on research and the development of new technologies to both save and improve lives. With more than 13,000 team members – physicians, surgeons, nurses, pharmacists and other highly-skilled health care professionals, UofL Health is focused on one mission: to transform the health of communities we serve through compassionate, innovative, patient-centered care. For more information on UofL Health, go to www.uoflhealth.org.

Job Summary:

Responsible for receiving and analyzing each account on the credit balance report(s).  Process refund requests from insurance groups and patients.  Prepare and submit Medicare Credit Balance detail report and Certification page on a quarterly basis as required by the authority of sections 1815(a), 1833(e), 1886(a)(1)(C) and related provisions of the Social Security Act.  Ensure patient balance is accurately stated after processing refund/adjustments on accounts with a credit balance.

Responsibilities

• Determine whether applied payments should be refunded by researching the payment, contractual, patient liability amounts.
• Gather information necessary, i.e. explanation of benefits to process refunds to the patient/guarantor.
• Review explanation of benefits to confirm how payments were applied to patient accounts.
• Analyze adjustments and submit necessary adjustments to be applied to the patient account.
• Complete refund requests on each credit and submit to leadership for approval.
• Maintain documentation for all communications, adjustments and refunds for retrieval and tracking purposes.
• Keep informed of all policies and procedures related to the refunds and audit processes and ensure adherence to all federal, state, and local regulatory billing guidelines as well as payer specific billing guidelines.
• Balance and log refunds processed daily.
• Monitors reasons adjustments/contractuals are creating credit balances and forwards any repetitive issues to leaderships attention. Determine “root causes” of erroneous credit balances.
• Ensure all account balances are correct prior to issuing refunds.
• Process refunds requested by patient within five (5) working days of receipt/request.
• Demonstrate the ability to work independently with minimum supervision.
• Complete tasks by deadline.
• Attend seminars as requested.
• Other duties as assigned.

Qualifications

MINIMUM EDUCATION & EXPERIENCE

• High School Diploma, or GED
• Two years of experience in AR Operations, accounting, or equivalent experience preferred

KNOWLEDGE, SKILLS, & ABILITIES

• Ability to analyze and interpret information on electronic remittances (ERA)/ Explanation of Benefits (EOB)
• Knowledge of insurance contracts
• Ability to meet productivity expectations