Refund Proc Rep Ld

Department:

10283 Enterprise Revenue Cycle - Credit Processing: Midwest

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

Remote M-F 7:00 am to 3:30 pm

Pay Range:

$24.10 - $36.15

Major Responsibilities:

Assists leadership with workflows, quality audits, training, ad hoc reporting, complex research, delegating work, and team member coaching. 

Regularly performs non-routine tasks independently that significantly impact the organization. 

Delegates assignments from vendor, audit, and compliance projects, ensuring completion within the appropriate time frame. 

Conducts high-level analysis of other team members' transactions before releasing them to payees or for next-level approval. 

Ensures continuous improvement by applying various experiences to look beyond issues and uncover the underlying causes of problems, credits, and refunds. 

Demonstrates a sense of ownership by providing solutions to critical issues and regularly engaging with peers and external partners as needed. 

Demonstrates expert-level knowledge of the Refund/Adjustment processes and utilizes systems/applications proficiently to resolve credit balances and process refunds appropriately. 

Approaches high-level problems from different angles, identifies ways to mitigate risks, and develops concrete solutions with little or no precedent. 

Leads efforts to reduce all credit balances and refunds for all Advocate Hospital Billing entities and Professional Billing within multiple patient accounting systems, ensuring appropriate contract reimbursement calculation rates are applied. 

Recommends and implements process enhancements, monitors account follow-up, and ensures timely processing of credits and refunds while acting as a resource to all team members and external partners. 

Works with leadership, level II's, operations, and the Revenue Cycle Process Designer as needed to update or draft workflow updates. 

Reads, interprets, and understands insurance correspondence including both explanation and coordination of benefits. 

Provides individual contributions to meet or exceed department goals by consistently meeting individual productivity and quality standards and targeted error ratios in processing credit balances 

Assists with patient accounting activities and functions typically performed by other Revenue Cycle positions during periods of high volume or impending deadlines. 

Coordinates to resolve issues requiring in-depth follow-up with leadership, physicians' offices, insurance companies, attorneys’ offices, or other internal departments while maintaining knowledge of insurance regulations and payer policies. 

Licensure, Registration, and/or Certification Required:

None Required.

Education Required:

High School Graduate 

Experience Required:

Typically requires 5 years of experience in healthcare business setting. 

Knowledge, Skills & Abilities Required:

Strong skill set in problem-solving across various settings, with critical analytical and investigation skills. 

Ability to motivate and direct team members' work and activities, including effective delegation. 

Demonstrates strong verbal, written, and interpersonal communication, with excellent grammar and spelling. 

Sets the climate for performance expectations and fosters a positive team environment. 

Pays attention to detail and maintains a high degree of accuracy. 

Exceptional time management and project management techniques, working efficiently under strict deadlines. 

Willingly accepts responsibility and applies appropriate leadership techniques in an operational setting. 

Proficient understanding of Microsoft Office. 

Strong knowledge of Managed Care payer contract terms and Medicare/Medicaid payer guidelines. 

Upholds ethical conduct in all activities. 

Regular and reliable attendance. 

Physical Requirements and Working Conditions:

Must be able to sit the majority of the workday.  

Operates all equipment necessary to perform the job. 

DISCLAIMER

All responsibilities and requirements are subject to possible modification to reasonably accommodate individuals with disabilities.

This job description in no way states or implies that these are the only responsibilities to be performed by an employee occupying this job or position.  Employees must follow any other job-related instructions and perform any other job-related duties requested by their leaders.

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

• Premium pay such as shift, on call, and more based on a teammate's job

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability

• Flexible Spending Accounts for eligible health care and dependent care expenses

• Family benefits such as adoption assistance and paid parental leave

• Defined contribution retirement plans with employer match and other financial wellness programs

• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.

About Advocate Health 

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.