Refund Specialist

ABOUT AUSTIN REGIONAL CLINIC:

Austin Regional Clinic is one of Central Texas' largest professional medical groups, with 35+ locations and a long history as a top Central Texas employer.

Purpose

Performs duties required to ensure accurate distribution of patient and insurance payments and appropriate adjustments to patient accounts while maintaining patient confidentiality and supporting the organization's mission.

Essential Functions

• Audits patient accounts to resolve credits and undistributed activity.
• Researches and resolves assigned credits through daily distributions and reports.
• Reviews carrier explanations of benefits to determine accurate carrier, provider, and patient responsibility.
• Opens payment posting or adjustment batches to perform account maintenance and balance claim activity.
• Distributes or redistributes payments and adjustments to the correct invoice and date of service.
• Generates adjustments necessary to complete accurate payment posting using appropriate A/R and ANSI codes.
• Ensures accurate transfer of outstanding balances to the next responsible party per payer explanation of benefits.
• Assists with training new employees.
• Compiles and submits patient and insurance refunds according to policy and procedure, including supporting documentation.
• Reviews and files secondary insurance claims with carrier explanations of benefits for designated plans.
• Documents account issues, sources, and resolutions in clear and accurate account notes.
• Obtains supervisor signature on large dollar write-offs according to policy.
• Follows established guidelines to complete report activity and meet month-end deadlines.
• Documents daily performance in a weekly productivity log.