Credit Balance Refund Rep
The posted compensation range of $17.89 - $24.60 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.
Opportunity to work from home (remote) after 90 days in the office.
**Local Candidates only**
Your time at work should be fulfilling.Rewarding. Inspiring. That’s what you’ll find when you join one of our non-profit CHI facilities across the nation. You’ll find challenging, rewarding work every day alongside people who have as much compassion as you. Join us and together we’ll create healthier, stronger communities.
Location: Service Center, Omaha NE
Hours: Flexible / Days
With you in mind, we offer the following benefits to support your work/life balance:
- Health/Dental/Vision Insurance
- Direct Primary Plan (No copay, no deductible, and access to CHI Health provider 24/7)
- Premium Access to our Family Care Program supporting your needs for childcare, pet care, and/or adult dependent care
- Voluntary Protection: Group Accident, Critical Illness, and Identity Theft
- Employee Assistance Program (EAP) for you and your family
- Paid Time Off (PTO)
- Tuition Assistance for career growth and development
- Matching 401(k) and 457(b) Retirement Programs
- Adoption Assistance
- Wellness Programs
- Flexible spending accounts
From primary to specialty care as well as walk-in and virtual services CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy. We offer more than 20 specialties and 100 convenient locations; with some clinics offering extended hours.
Responsibilities
JOB SUMMARY / PURPOSE
This job is responsible for facilitating the resolution of insurance and patient credit balances and issuing/requesting refunds, immediate offsets and/or redeterminations as appropriate for patient satisfaction and compliance with applicable regulations. Work includes responsibility for the timely and accurate resolution of all credit balance accounts and any action on accounts that result in unapplied activity.
An incumbent researches accounts to determine whether: 1) a refund is appropriate to either the patient or the insurance company; 2) a payment transfer is needed; or 3) a reversal of contractual allowance or administrative adjustment is warranted.
Work requires an understanding of detailed billing requirements and insurance follow-up practices, as well as attention to detail, and the ability to accurately and timely troubleshoot/resolve (within scope of the position) resolution of refunds issues.
ESSENTIAL KEY JOB RESPONSIBILITIES
1. Reviews accounts and/or reports, including: Explanation of Benefits (EOB)/ Electronic Remittance Advice (ERAs), payments, adjustments, insurance contracts and contracting system, insurance benefits, and all account comments; contacts and communicates with insurance companies to gather additional information, as necessary.
2. Refunds overpayments on accounts and transfers payments to the appropriate accounts.
3. Verifies all patient account charges are billed to the insurance plan.
4. Validates that insurance has paid correctly and identifies any patient responsibility.
5. Conducts appropriate review to accurately transfer payments in accordance with established procedures.
6. Proactively identifies, researches and resolves (with position scope) unusual, complex or escalated issues, as necessary.
7. Notifies Supervisor/Manager of ongoing issues and concerns.
8. Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records.
9. Adheres to refund approval protocols for non-routine refunds.
10. Meets quality assurance and productivity standards through identification, reconciliation of credit balance accounts and review of credit balance reports for potential overpayments in accordance with organizational policies and procedures.
Qualifications
Highly Preferred Candidate who has three years of experience of revenue cycle in Healthcare
Graduation from a post-high school program in medical billing or other business-related field is preferred.
High School Diploma or GED preferred.
Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.
Apply
Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible employees may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit https://www.commonspirit.careers/benefits.
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Equal Opportunity
CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here [PDF].
CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.