Opportunity to work from home (remote) after 6 months in the office.

• Pay range starts at $17.89/hr and goes up based on experience and pay equity within the department

Your time at work should be fulfilling. Rewarding. Inspiring. That’s what you’ll find when you join one of our non-profit CHI facilities across the nation. You’ll find challenging, rewarding work every day alongside people who have as much compassion as you. Join us and together we’ll create healthier, stronger communities.

Location: Service Center, Omaha NE

Hours: Flexible / Days

JOB SUMMARY / PURPOSE

This job is responsible for facilitating the resolution of insurance and patient credit balances and issuing/requesting refunds, immediate offsets and/or redeterminations as appropriate for patient satisfaction and compliance with applicable regulations. Work includes responsibility for the timely and accurate resolution of all credit balance accounts and any action on accounts that result in unapplied activity.
An incumbent researches accounts to determine whether: 1) a refund is appropriate to either the patient or the insurance company; 2) a payment transfer is needed; or 3) a reversal of contractual allowance or administrative adjustment is warranted.
Work requires an understanding of detailed billing requirements and insurance follow-up practices, as well as attention to detail, and the ability to accurately and timely troubleshoot/resolve (within scope of the position) resolution of refunds issues.

ESSENTIAL KEY JOB RESPONSIBILITIES

1. Reviews accounts and/or reports, including: Explanation of Benefits (EOB)/ Electronic Remittance Advice (ERAs), payments, adjustments, insurance contracts and contracting system, insurance benefits, and all account comments; contacts and communicates with insurance companies to gather additional information, as necessary.
2. Refunds overpayments on accounts and transfers payments to the appropriate accounts.
3. Verifies all patient account charges are billed to the insurance plan.
4. Validates that insurance has paid correctly and identifies any patient responsibility.
5. Conducts appropriate review to accurately transfer payments in accordance with established procedures.
6. Proactively identifies, researches and resolves (with position scope) unusual, complex or escalated issues, as necessary.
7. Notifies Supervisor/Manager of ongoing issues and concerns.
8. Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records.
9. Adheres to refund approval protocols for non-routine refunds.
10. Meets quality assurance and productivity standards through identification, reconciliation of credit balance accounts and review of credit balance reports for potential overpayments in accordance with organizational policies and procedures.

Three years of revenue cycle or related work experience that demonstrates attainment of the requisite job knowledge and abilities preferred.
Graduation from a post-high school program in medical billing or other business-related field is preferred.
High School Diploma or GED preferred.