Refund Specialist

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Do you want to use your problem solving skills and knowledge of finance to help heal America's workforce? At Concentra, we serve more than 500 medical centers and 130 onsite clinics nationwide. Concentra colleagues remain fueled by our driving purpose: to provide outstanding patient experience by delivering the highest quality healthcare in an efficient, affordable, and caring manner. We do this by putting all customers first.

Position Summary

The Central Billing Office (CBO) Refund Specialist performs a variety of tasks researching refund requests, overpayments, and credit balances. The Specialist ensures money is correctly applied and overpayments are refunded to the appropriate party.

The Details

• Analyze and resolve credit balances on medical billing system
• Review and respond to various patient, customer, or insurance refund requests
• Understand payer contracts and prepare refund requests accordingly
• Review refund requests or credit balances on daily basis for completeness by comparing documentation against specific supporting back-up
• Submit refund requests in good order to appropriate supervisor for approval
• Prepare refund request forms and supporting documentation regarding overpayments
• Identify and share payment/adjustment trends with supervisor to assist in on-going training of CBO colleagues
• Perform daily, weekly, and monthly balancing of all posting activity
• Identify billing errors, inaccurate payments or posting errors to resolve balances on practice management system
• Research credits on account receivables, unapplied balances and resolves balances
• Reconcile receipt summaries and resolves balances
• Contact payers (non-injury and injury) to determine if payments can be applied and process paperwork for payment transfer
• Research and process refund transactions such as duplicate payments and checks received in error
• Research and transfer unidentified payments to appropriate accounts/charges where approved
• Research and pull copies of previously paid checks
• Process refund request spreadsheets/forms and makes appropriate copies
• Submit electronic refund requests to accounts payable with manager approval and documents request date
• File and maintain refund copies
• This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Concentra is a national health care company focused on improving America’s workforce, one patient at a time. Through our affiliated clinicians, we provide occupational medicine, urgent care, primary care, physical therapy, and wellness services. Concentra also serves employers by providing a broad range of onsite health services in worksite medical facilities.

Education/Credentials

• High school diploma or GED equivalent
• Some college or specialty training in medical billing or equivalent job relevant experience preferred

Job-Related Experience

• Customarily has at least one or more years of experience in accounts receivable or payment posting

Job-Related Skills/Competencies

• Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility
• Ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions
• Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism
• The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies
• Familiarity with Microsoft Excel, Outlook, Word
• Ability to communicate effectively
• Time management and organizational skills
• Familiarity with refund process
• Familiarity with medical coding
• Analytical and data entry skills
• Ability to operate 10-key numeric pad by touch