Bayhealth
Insurance Credits and Refunds Specialist
1 day ago Be among the first 25 applicants
This range is provided by Bayhealth. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base pay range $18.73/hr - $28.09/hr
Overview Bayhealth Medical Center is Central and Southern Delaware’s healthcare leader with hospitals in Dover and Milford, as well as stand‑alone Emergency Department in Smyrna and a hybrid Emergency Department and Urgent Care in Milton. We offer various practice settings throughout Kent and Sussex Counties. Bayhealth Medical Center Kent Campus is 90 minutes from Philadelphia, Washington, DC and Baltimore. Our Sussex Campus is 30 minutes to the Delaware beaches and relaxation in the sand!
Benefits
Generous Paid Time Off and Paid Holidays
Matching 401(k)/403(b) Plans
Excellent Health, Dental, and Vision
Disability and Life Insurance options
On Site Child Care
Educational Reimbursement
Health Care and Dependent Care Flex Spending Accounts
Plus, an array of Voluntary Benefits to include Critical Care Coverage and more!
Location Kent Campus Hospital
Status Full Time 80 Hours
Shift Days
Salary Range $18.73 - $28.09 hourly
General Summary Responsible for reconciling patient accounts that remain in credit balance status due to overpayment, contract adjustment posting errors, and other issues. Follows proper control procedures for issuing refunds. Investigates and reports trends of issues which result in credit balances. Must be able to correctly interpret insurance contracts making adjustment or refund determinations with little to no assistance.
Responsibilities
Responsible for researching accounts in a credit balance status and taking the necessary steps to resolve the credit balance. Review remittance advice and other correspondence to correct account balance and/or identify refunds due. Calls payers as appropriate to obtain additional insight into claim processing and payment amount(s). Document outcome of research and actions taken to resolve the credit balance.
Correctly interprets Federal and State regulations for Medicare and Medicaid and contract terms for Managed Care, Commercial, and Workers Compensation as applicable to ensure all income is appropriately recorded.
Follows proper control procedures and departmental policy for posting necessary contractual, small balance and/or refund adjustments. Timely and accurate submission of adjustments and refund requests for approval based on departmental approval guidelines.
Identifies trends and coordinates with SBO Cash Application staff to reduce the volume of credit balance accounts generated from posting activities in the future.
Prioritizes work to ensure department and corporate goals are met.
Maintains productivity standards and credit balances less than the value of 1 day of average daily revenue.
All other duties as assigned within the scope and range of job responsibilities.
Required Education, Credential(s) and Experience
Education: High School Diploma or GED.
Credential(s): None required.
Experience: Three years’ experience in hospital billing and collections. Preferred: Four years hospital billing and collections experience.
Preferred Education, Credential(s) and Experience
Education: Associate Degree.
Credential(s): Certified Revenue Cycle Specialist.
Experience: Not specified.
Seniority level Not Applicable
Employment type Full-time
Job function Administrative
Industries Hospitals and Health Care
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This range is provided by Bayhealth. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base pay range $18.73/hr - $28.09/hr
Overview Bayhealth Medical Center is Central and Southern Delaware’s healthcare leader with hospitals in Dover and Milford, as well as stand‑alone Emergency Department in Smyrna and a hybrid Emergency Department and Urgent Care in Milton. We offer various practice settings throughout Kent and Sussex Counties. Bayhealth Medical Center Kent Campus is 90 minutes from Philadelphia, Washington, DC and Baltimore. Our Sussex Campus is 30 minutes to the Delaware beaches and relaxation in the sand!
Benefits
Generous Paid Time Off and Paid Holidays
Matching 401(k)/403(b) Plans
Excellent Health, Dental, and Vision
Disability and Life Insurance options
On Site Child Care
Educational Reimbursement
Health Care and Dependent Care Flex Spending Accounts
Plus, an array of Voluntary Benefits to include Critical Care Coverage and more!
Location Kent Campus Hospital
Status Full Time 80 Hours
Shift Days
Salary Range $18.73 - $28.09 hourly
General Summary Responsible for reconciling patient accounts that remain in credit balance status due to overpayment, contract adjustment posting errors, and other issues. Follows proper control procedures for issuing refunds. Investigates and reports trends of issues which result in credit balances. Must be able to correctly interpret insurance contracts making adjustment or refund determinations with little to no assistance.
Responsibilities
Responsible for researching accounts in a credit balance status and taking the necessary steps to resolve the credit balance. Review remittance advice and other correspondence to correct account balance and/or identify refunds due. Calls payers as appropriate to obtain additional insight into claim processing and payment amount(s). Document outcome of research and actions taken to resolve the credit balance.
Correctly interprets Federal and State regulations for Medicare and Medicaid and contract terms for Managed Care, Commercial, and Workers Compensation as applicable to ensure all income is appropriately recorded.
Follows proper control procedures and departmental policy for posting necessary contractual, small balance and/or refund adjustments. Timely and accurate submission of adjustments and refund requests for approval based on departmental approval guidelines.
Identifies trends and coordinates with SBO Cash Application staff to reduce the volume of credit balance accounts generated from posting activities in the future.
Prioritizes work to ensure department and corporate goals are met.
Maintains productivity standards and credit balances less than the value of 1 day of average daily revenue.
All other duties as assigned within the scope and range of job responsibilities.
Required Education, Credential(s) and Experience
Education: High School Diploma or GED.
Credential(s): None required.
Experience: Three years’ experience in hospital billing and collections. Preferred: Four years hospital billing and collections experience.
Preferred Education, Credential(s) and Experience
Education: Associate Degree.
Credential(s): Certified Revenue Cycle Specialist.
Experience: Not specified.
Seniority level Not Applicable
Employment type Full-time
Job function Administrative
Industries Hospitals and Health Care
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