The Refund Specialist-Insurance is responsible for reviewing accounts, identifying insurance overpayments and credit balances, as well as evaluating and verifying refunds are issued in accordance with current policies and procedures.Duties & ResponsibilitiesReview refund and overpayment requests from insurance payers to determine if overpayment has occurredReview and resolve credit balances through credit transfers, account corrections and refund request form completion for manual refund check requestsIdentify root causes and trends contributing to patient and insurance credit balancesProactively work with other revenue cycle departments to improve efficiency and reduce and/or eliminate refund issuesPosts debits for approved refundsResearch returned checks and collaborates with A/P for reporting to unclaimed propertyResolves Department credit balance inquiries for transfers and refund check requestsAbility to work collaboratively and build positive business relationships with clinical areas and the payer communityDevelop and maintain expertise with payer specialty-specific payment policiesMaintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedurePreform special projects as requiredQualifications & CompetenciesBA/BS in accounting, business, finance or an equivalent combination of training and experience is necessary3 years'+ experience in health care /managed care environment, preferably in a large physician practice or a combination of experience and education1 year+ of experience with complex refunds to insuranceKnowledgeable in physician reimbursement and managed care claim payment issues.Excellent communication skills and ability to effectively communicate with various levels of management in a multi-disciplinary environmentUnderstanding of electronic medical record and billing system Pricing Module and fee schedulesStrong analytical skills with attention to detailAdvanced level Excel and financial analysis related to physician reimbursementAbility to do math calculations, input data into the computer, and analyze data as requested.Must be willing to work onsite in Ortigas, Pasig City#J-18808-Ljbffr