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Moses Cone Health System

Refund Rep Revenue Cycle

Moses Cone Health System - Greensboro, NC



Job Description
Hours: Monday - Friday, 8 am - 5 pm, 40 hours/weekLocation: Greensboro, NCEDUCATION:Required:High School Diploma or its equivalency Preferred:Associate DegreeJOB SUMMARY:This position is responsible for accurately analyzing and performing the appropriate disposition of all revenue cycle credit balances and refund requests. Ensures that the disposition of credit balances are completed as defined in all Contractual, Regulatory and Corporate Compliance requirements.MAJOR WORK ACTIVITIES (MWA’S):1. Analyze account credit balances to ensure accuracy of account for appropriate payments and adjustments according to regulatory laws and hospital contracts meeting all timely requirements. (30%)• Thoroughly reviews self pay credit balance accounts appropriately abiding by all insurance rules, regulations and contracts, processing patient refunds within 45 days of their occurrence.• Thoroughly reviews insurance credit balance accounts appropriately abiding by all insurance rules, regulations and contracts processing insurance refunds as necessary within 90 days of their occurrence.• Accurately post correct adjustments or reverses incorrect adjustments related to credit balances/ overpayment of accounts• Effectively communicates status with patients, payors, physicians and others.2. Responds to requests. (20%)• Promptly responds to correspondence and communication regarding patient accounts for review and analysis.• Properly evaluates priorities and organizes time accordingly so that required activities are completed on a timely basis.3. Follows prescribed procedures for the control documentation, verification and processing of refund request. (15%)• Ensures refund amount is correct and verified prior to submission for payment• Accurately enters required information into patient account notes so that responses to inquiries and patient account status can be responded accurately and timely• Maintains a comprehensive filing system for designated records and administrative data with appropriate indexing, so that documents can be retrieved easily by authorized persons searching for information.4. Maintain acceptable level of quality and production standards as determined by supervisory review and audit of assigned account categories. (10%)• Notifies manager of possible or potential issues that may result in delays in processing credit balances.5. Regulatory Logs and Reporting (15%)• Accurately identifies all credit balances that must be reported to government agencies• Prepares and submits the credit balance logs quarterly as mandated by federal /state regulations6. Properly evaluates priorities and organizes time accordingly so that required activities are completed on a timely basis (with no more than 2-4 avoidable exceptions noted per year). (10%)WORKING CONDITIONS: Occurs under one-third of the time: Exposure to bloodborne pathogens Hazardous waste and/or toxic/caustic chemicalsFumes or airborne particlesAdditional information on Working Conditions:Sufficient mobility to travel within and between health system facilities. Ability to visualize the computer monitor and use automated communication devices such as fax, voicemail and email.iCARE - COMMITMENTS TO CARE:Communication I will create and engage in conversations of possibility. I will be open to innovation and creativity. I will listen to understand. I will bring ideas for solutions and be open to alternative ideas. I will be open to constructive feedback. I will not engage or listen to negativity or gossip. I will be positive when speaking about Cone Health, my department, and my coworkers. I will be approachable. I will focus on behaviors, not the person, during conflict.Accountability I will honor my word. I will do what I say when I say I will. I will “clean it up” when I can’t keep my word. I will honormy work agreement. I will be “on the court” instead of “in the stands.” I will follow up in a timely manner on commitments and requests. I will apologize when someone experiences less than excellent service. I will take responsibility for my actions, decisions and performance. I will protect patient safety (best practices: ex – hand hygiene).Respect I will assume the best of intentions and embrace differences. I will collaborate and seek other people’s input. I will demonstrate courtesy, compassion, and respect with my tone of voice and body language. I will speak positively about Cone Health – managing up coworkers, physicians, departments, patients and visitors. I will ask the person directly involved when I don’t know. I will include diverse skills, abilities, strengths, and backgrounds to create better outcomes. I will care for myself while also respecting others.Empowerment I will own it, solve it, and celebrate it! I will offer solutions when problems are identified. I will share my input for decisions by participating in forums such as shared governance, town halls, employee engagement survey, brown bag discussions, employee councils, staff meetings, or directly with my manager. I will take charge and do the right thing at the right time. I will make decisions keeping a balance of service, quality, and cost in mind. I will demonstrate Cone Health values. I will seek opportunities to celebrate and have fun. I will recognize good work.I have seen and reviewed the job description in its completed form and understand that I will be required to perform all functions listed if hired for this position. I recognize that, if hired, it is my responsibility to notify my manager as soon as possible if I am unable to perform any of the functions of my position for any reason. This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job.Exceptional People Providing Exceptional Care!Cone Health is a state of the art network of facilities providing patients access to the latest developments in medical care from their first moments of life through later years. Our network offers the most breakthrough treatments and technology available in healthcare today. As a teaching hospital, we offer employees the opportunity to become leaders in the industry and continued growth from their first day on.Extraordinary patient care is about being “high-touch” as well as “high-tech”. Community service and superior patient care are the cornerstones of our organization, a philosophy that is demonstrated by each and every one of our valued team members. We are proud to be the largest private, not-for-profit employer of choice in the Piedmont, NC area community!Cone Health is an equal opportunity employer. If you require assistance with our online job submission process, please contact our Talent Acquisition team at 866-266-3767 to request an accommodation. Additionally, Cone Health invites interested deaf and hard of hearing applicants to use Video Relay Service (VRS).EXPERIENCE:Required:Minimum 3 years experience in accounting, banking or hospital, medical office setting.Preferred:4-5 years’ experience in accounting, banking or hospital, medical office setting.ICD and CPT Coding experience.KNOWLEDGE, SKILLS AND ABILITIES:Required:•Excellent verbal and written communication skills required. Ability to communicate with payors, regulatory agencies, hospital departments, physicians, patients and employees.•Excellent organizational skills•Ability to work independently•Proficient in excel and word Considerable knowledge of insurance and government rules and regulations.Preferred:ICD & CPT coding experiencePHYSICAL REQUIREMENTS:Sedentary Work:• Exerting up to 10 pounds of force occasionally (up to 1/3 of the time) and/or;• A negligible amount of force frequently (1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body.• Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time.• Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.HEARING / VISION:•Hear and differentiate low volume sounds in order to make judgments regarding actions needed•Hear alarm bells, verbal conversations, telephone voices and normal volume sounds•Close vision (clear vision at 20 inches or less) •Distance vision (clear vision at 20 feet or more) TESTING/COMPETENCY:Must satisfactorily complete required workstation testing in Data Entry and Basic Excel and WordCONDITIONS OF EMPLOYMENT:• Annual flu shot• Annual TB test (if applicable to your job location)• Annual CBL’s (Safety at Work and Corporate Compliance)• Maintain licensure/certification/registry/listing without lapse (if applicable to your job)

6 days 19 hours ago

Moses Cone Health System

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Refund Rep Revenue Cycle Moses Cone Health System - Greensboro, NC, United States

   

Location: Greensboro, NC

Company Profile:
Moses Cone Health System is a multi-hospital system with a range of outpatient services designed to provide care for Piedmont residents throughout all stages of their lives. Residents of our primary service area of Guilford, Randolph, Rockingham and Alamance counties and the city of Kernersville depend on us for convenient, affordable and compassionate care - care delivered regardless of a patient s ability to pay.