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Analyst 3, Credit & Collection

Company: TechDigital Corporation
Location: Stuart
Posted on: June 6, 2021

Job Description:

PRI-Refunds Representative 8-Hour Shift between 7:00am-5:00pm EST; Mandatory OT on last week and weekend of the month based off business need ***Must have high speed WiFi connection and place to setup home office to work remotely temporarily however, will be required to report on-site. Local or candidates within commuting distance needed.

Pay Rate *** Bill Rate *** OT Bill Rate *** I***

POSITION PURPOSE T
o process medical billing claims, collect patient or provider payments, resolve questions and problems with customers accounts, process patient refunds, appeals to include re-determinations and re-submissions of billing to patient payers for payment on medical supply orders To accurately identify and complete offset/recoupment and/or refund requests to various payers, as well as, patients, resolve questions and problems with patient refunds, and submit appeals and disputes for involuntary offsets/recoupments/chargebacks II. PRIMARY DUTIES AND RESPONSIBILITIES 1. Receive payment denials and to investigate the reason and rectify the situation with the payer or patient 2. Review all returned supplies to determine even exchange versus partial and full product returns 3. Review all internal and external refund requests to accurately identify if an overpayment was made and/or if a refund is due to the payer and/or patient 4. Complete the necessary forms and/paperwork to request a voluntary offset/recoupment/refund request when applicable within the amount days dictated by the payer and/or contractual obligations 5. Request and/or complete claim adjustments and/or voids to ensure that claims for supplies that have been returned or claims billed in error have been voided/adjusted in the payers system to reflect accurate information when applicable within the amount days dictated by the payer and/or contractual obligations 6. Receive inbound and place outbound calls from and to customers, Medicare, Medicaid and Commercial insurance providers regarding patient accounts 7. Provide written correspondence to audit requests to include investigation and obtaining of appropriate documentation to be attached to response 8. Document status of billing and payment process in patient account for future follow-up 9. Keep current on payer requirements via research and coaching to ensure guidelines and procedures are being met for each payer 10. Answer and follow up on calls from patients with billing questions 11. Complete all end of month reports as requested, directed or assigned 12. Complete all internal system service ticket requests as assigned 13. Work miscellaneous projects and tasks on an as needed basis 10. III. ANCILLARY DUTIES AND RESPONSIBILITIES 1. Maintain a positive work atmosphere that embodies Liberators philosophy- Professional excellence, teamwork and integrity. 2. Maintains a production level between 20-40 accounts per day ensuring quality of work is above average. Production rates are at the discretion of management and are subject to change with our without prior notification. 3. Maintains a better than average attendance score 4. Performs other duties and tasks as assigned IV. REPORTING RELATIONSHIP RESPONSIBILITIES __x__ No supervisory responsibilities __ ___ Provides work direction only _____Provides work direction plus has responsibility for hiring, promotions, transfers, performance management, discipline, and discharge. V. MINIMUM REQUIREMENTS OR QUALIFICATIONS (To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions) a. Education/Experience: High School Diploma or general education degree (GED); two to four years prior medical supply billing experience and/or 1-3 years prior experience as an AR Billing Representative I exceeding performance levels and expectations for that role. b. Skills: 1. Language: Ability to read, analyze, and interpret medical supply publications, technical procedures, and/or training tools. Ability to write internal and external business correspondence. Ability to effectively present information and respond to questions from management, team members, and/or customers. 2. Math: Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages. Ability to apply intermediate math skills. 3. Reasoning: Ability to solve practical problems and deal with a variety of variables. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Advanced analytical reasoning to include ability to forecast exponentials within work flow processes and reason against outside factors. 4. Computer: Knowledge of Microsoft Office Applications, Access or other database software. 5. Telecommunications: ability to utilize or knowledge of call center telecommunications software c. Licensure or Certifications required: No certifications required VI. WORK REQUIREMENTS 1. Ability to work some evening shifts, weekends, and overtime as needed VII. PHYSICAL DEMANDS (The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. )While performing the duties of this job, the employee is frequently required to walk, sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand. The employee must occasionally lift and/or move up to 10 lbs. VIII. WORK ENVIRONMENT (The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. ) While performing the duties of this position, the employee performs tasks in a temperature controlled office environment under normal office conditions. The noise level in the work environment is usually moderate. The work environment involves minimal exposure to hazards or physical risks, which require following basic safety precautions. IX. DISCLAIMER The above job description is meant to describe the general nature and level of work being performed; it is not intended to be an exhaustive list of all responsibilities, duties, and skills required for this position. The Company officers, mid-level, and entry level management staff may assign additional duties and responsibilities as needed. This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees will be required to follow any other job-related duties requested by their supervisor in compliance with Federal and State Laws.

Keywords: TechDigital Corporation, Palm Beach , Analyst 3, Credit & Collection, Other , Stuart, Florida

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