Refund Escalation Specialist
Refund Escalation Specialist
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Job Description
About Us
Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia emergency medicine hospital medicine pathology and radiology. Focused on Revenue Cycle Management Ventra partners with private practices hospitals health systems and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues enabling clinicians to focus on providing outstanding care to their patients and communities.
Job Summary
- The Refund Escalation Specialist is responsible for the monitoring and resolving Credit balances and refunds from billing systems overages. Daily assignments are provided by the supervisor and the Refund Escalation Specialist must develop a plan to complete work lists by the end of each day. The Refund Escalation Specialists must comply with applicable laws regarding billing standards and be able to operate in a team-oriented environment that strives to provide superior service to our providers throughout the country.
Essential Functions and Tasks
- Processes research and resolves credit balances and refunds from a billing systems overages that are escalated from the Credit team.
- Reviews refund request letters and determines an appropriate resolution based on contract and timely guidelines.
- Identifies trends and notifies appropriate departments.
- Ensure that all check registers are sent to Client Success or finance for Approval.
- Ensure we receive all check numbers from Client to be uploaded into the system to ensure Credits can be cleared.
- Ensure all returned refund checks are researched and corrected.
- Analyzes data from various reports and makes recommendations accordingly.
- Performs special projects and other duties as assigned.
Education and Experience Requirements
- High School Diploma or Equivalent.
- Two (3) year of experience posting insurance payments in a healthcare setting.
- Two (3) years of experience reading insurance Explanation of Benefits (EOB) statements preferred.
Knowledge Skills and Abilities
- Knowledge of Explanation of Benefits (EOB) statements.
- Knowledge of a variety of insurance plans.
- Strong oral written and interpersonal communication skills.
- Strong word processing spreadsheet and database software skills.
- Strong mathematical skills in addition subtraction multiplication and division of whole numbers and fractions; computing percentages; and working with decimal.
- Strong time management skills.
- Strong organizational skills.
- Ability to read understand and apply state/federal laws regulations and policies.
- Ability to take initiative and effectively troubleshoot while focusing on innovative solutions.
- Ability to remain flexible and work within a collaborative and fast paced environment.
- Ability to communicate with diverse personalities in a tactful mature and professional manner.
Ventra Health
Equal Employment Opportunity (Applicable only in the US)
Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates and all qualified applicants will receive consideration for employment without regard to race color ethnicity religion sex age national origin disability sexual orientation gender identity and expression or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities as needed to assist them in performing essential job functions.
Recruitment Agencies
Ventra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.
Solicitation of Payment
Ventra Health does not solicit payment from our applicants and candidates for consideration or placement.
Attention Candidates
Please be aware that there have been reports of individuals falsely claiming to represent Ventra Health or one of our affiliated entities Ventra Health Private Limited and Ventra Health Global scammers may attempt to conduct fake interviews solicit personal information and in some cases have sent fraudulent offer letters.
To protect yourself verify any communication you receive by contacting us directly through our official channels. If you have any doubts please contact us at to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on of Accessibility
Ventra Health is committed to making our digital experiences accessible to all users regardless of ability or assistive technology preferences. We continually work to enhance the user experience through ongoing improvements and adherence to accessibility standards. Please review at Experience:
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