REQUIRED QUALIFICATIONS:
Bachelor’s Degree from Accredited University
Five (5) plus years of work experience in a leading role with direct reports
Experience leading individuals or a team in a healthcare environment
Extensive knowledge in processing Credit and Refund invoices
Five (5) years’ experience in refunds/credits industry, accounting, insurance, healthcare returns, refunds and credits, collections, claims processing, which may include experience with government, commercial, and other third-party payers, interpreting EOBs, EOMBs, RAs and other related documents
Experience with MS Office suite (Word, Excel, Outlook), and internet and web site navigation
Knowledge of GE Centricity and SAP system
REQUIRED KNOWLEDGE:
Bachelor’s degree in Healthcare Management
Handle processing of QR’s and DRQ’s
Intermediate knowledge of payer refunds and credit regulations and compliance issues as well as knowledge of return process
Experience in interpreting EOBs, EOMBs, and RAs. Experience with ICD9, HCPCS, and CPT coding
Intermediate knowledge of insurance contracting, payer regulations, managed care and compliance, with demonstrated experience in managed Medicare and Medicaid programs.
Intermediate to advanced knowledge of and experience with basic Microsoft programs including Word, Excel and Power Point, with demonstrated ability to prepare thoughtfully organized memoranda, letters, spreadsheets, charts and graphs, and various presentations.
Demonstrated analytical skills to identify and triage issues with Accounts Receivable Management
Excellent written and verbal communication skills
PHYSICAL JOB REQUIREMENTS:
Ability to sit, wear a headset, work on the computer for extended periods of time
Ability to lift 5lb ream of paper
Ability and willingness to work flexible hours and varying daytime shifts, including after-hours support