The System CPO Refund Analyst is responsible for conducting audits of credit balances and monitoring refund request from Medical Billing staff. Applies professional auditing principles and will follow established procedures for credit balance/refund resolutions.
INTEGRIS Health is an Equal Opportunity/Affirmative Action Employer.
The System CPO Refund Analyst responsibilities include, but are not limited to, the following:
* Runs credit balance reports to perform audits of accounts with credit balances to determine what procedure(s) should be followed to eliminate the credit balance.
* Reviews all refund requests from Medical Billing Specialist for accuracy and to ensure the refund is compliant with INTEGRIS Medical group refund policies and procedures.
* Posts all appropriate transactions to process refunds, or eliminate credit balances on patient accounts.
* Assists Medical Billing Specialist with payor recoupments.
* Processes weekly refund reports and download refund interface the Accounts Payable Department.
* Reviews and resolves claim overpayment issues in assigned hold buckets in the practice management system.
* Interacts with Compliance Department to resolve and process any appropriate refunds after audit adjustments have been made.
Reports to the Central Processing Office (CPO) Supervisor, CPO manager, CPO director
Required Physical Demands (Subject to Reasonable Accommodation):
Keyboarding/Dexterity: Frequently; activity exists from 1/3 to 2/3 of the time
Standing/Walking: Occasionally; activity exists up to 1/3 of the time
Strength (Lift/Carry/Push/Pull): Sedentary (exerting up to 10 pounds of force occasionally)
Talking (Must be able to effectively communicate verbally): Yes
Color Acuity (Must be able to distinguish and identify colors): No
This position may have additional or varied physical demand and/or respiratory fit test requirements. Please consult the Physical Demands Project SharePoint site or contact Risk Management/Employee Health for additional information.
All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.
*High School diploma or equivalent
* 2 years college preferred
* 3 years of Medical Billing experience
* Knowledge of Medicare, Medicaid, and third party reimbursement rules and regulations, contractual adjustments and interpretation of third party payor EOB's.
* Must be able to communicate effectively in English (verbal/written).