Refund Coordinator II

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Job description

Job Functions, Duties, Responsibilities and Position Qualifications:

Job Description

The Refund Coordinator will be responsible for researching and processing all potential overpayments, refund requests, credit balances for guarantors or payers, and appealing any recoupments that are deemed incorrectly processed by payers. This position is responsible for ensuring money is correctly applied and refunded to the appropriate party in a timely manner in accordance with guarantor and payer refund policies.

Location: Dallas, Texas 75247

Days: Monday - Friday

Hours: 6:30 AM - 3:00 PM

Full-time: Benefit Eligible

Hybrid Schedule/Not fully Remote

In this role, you will:

• Understand all aspects of the billing system to properly perform job responsibilities.
• Use proper appeals/reconsideration protocol specific to each health plan as required for refund requests and recoupments that are according to contract
• Research and process refund requests from insurances accurately and in a timely manner.
• Research payer policies to ensure proper processing and resolution of refund requests and recoupments
• Contact insurance companies as needed for appeals/reconsideration status on outstanding appeals for recoupments
• Research and correct credit balances accordingly to open balances or proper transactions for patient accounts.

• Assist with resolving incoming refund inquiries via phone or email.
• Perform proper adjustments on accounts to reflect correct balance to guarantor or payer.
• Use proper grammar and reason on letters/forms to patients and payers to reduce confusion related to refund.
• Communicate refund trends to management as identified.
• Meet daily/monthly productivity and QA goals.
• Work special projects as needed.
• Provide quality, timely and professional internal and external customer service.

Primary Duties:

• Maintain compliance with department and company policies and procedures.
• Maintain compliance with federal and state regulations.
• Maintain confidentiality of employee, patient, client and/or company records and issues.
• Adhere to department schedule to meet workflow demands.
• Work effectively within a team-oriented department and company.
• Work overtime as needed.
• Other related duties as assigned.

EDUCATION/KNOWLEDGE:

High School diploma or equivalent. Some related college courses helpful.

EXPERIENCE:

Minimum 2 years medical billing experience required, specifically related to denials management or appeals. Familiarity with Medicare guidelines. Laboratory or pathology billing experience a plus, but not required.

Company:

Sonic Anatomic Pathology.

Scheduled Weekly Hours:

40

Work Shift:

1st Shift (United States of America)

Job Category:

Accounts Receivable

Company:

ProPath Services, LLC

Sonic Healthcare USA is an equal opportunity employer that celebrates diversity and is committed to an inclusive workplace for all employees. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, age, national origin, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

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