Patient Accounting Representative I - Reimbursement-Refunds

Staff_02 Halifax Staffing Inc.; Daytona Beach (FL); On-site; USD 45,000 - 65,000; Full time

Job summary

Halifax Health in Daytona Beach, FL seeks a Patient Accounting Representative I - Reimbursement-Refunds to manage insurance and patient credit balances and refund requests within the Revenue Cycle.

You will apply contracts, request adjustments, and process refunds while tracking trends for process improvement. The role requires attention to detail, strong communication, and HIPAA compliance in a busy hospital accounting environment.

Qualifications

• Associate degree or 2+ years in related field; substitution allowed.
• 2+ years healthcare experience in reimbursement methodologies including managed care, Medicaid, Medicare.
• Knowledge of electronic remittance posting, EOB interpretation, cash applications, and batch posting.
• Experience in third party billing and hospital collections.
• Strong analytical, communication, and organizational skills.
• Self-starter able to work with minimal supervision.
• Proficient in Outlook, Word, and Excel.
• Ability to meet deadlines under stress.

Responsibilities

• Process third party and patient refunds per policy.
• Research credit balance accounts for refunds.
• Review refund requests from insurance or audits for validity.
• Send adjustments, posting corrections, or transfers to Payment Poster.
• Coordinate refunds with third party vendors.
• Prepare letters or faxes disputing refunds.
• Call insurers for additional credit balance information.
• Complete audits from insurers or internal compliance.
• Submit refund posting reports weekly.
• Maintain HIPAA privacy and professional relationships.
• Perform other duties as assigned.

Skills

Healthcare reimbursement knowledge

Remittance posting

EOB interpretation

Third party billing

Analytical skills

Communication skills

Organizational skills

MS Office (Outlook/Word/Excel)

Self-motivation

Deadline management

Education

Associate’s Degree in Accounting/Business/Finance

2+ years related experience substitution for degree

Tools

Remittance posting software

Accounts receivable software

Job description

Day (United States of America) Patient Accounting Representative I - Reimbursement-Refunds

Will be responsible for working insurance and patient credit balances and refund requests. This individual plays an active role in the Revenue Cycle by accurately applying contracts, requesting adjustments and refunding overpayments while tracking and trending for process improvement. Keeps management apprised to any issues related to credit balances and posting.

Job Qualifications

• Associate’s Degree in Accounting, Business Administration, Finance or at least two (2) years in a related field which can be substituted for a degree.
• Preferred minimum of two (2) years of healthcare experience in the area of reimbursement methodologies including managed care contracts, Medicaid and Medicare.
• Preferred knowledge of electronic remittance posting, interpretation of explanation of benefits, cash applications and batch posting processes.
• Preferred knowledge in third party billing and collections in a hospital setting.
• Excellent analytical, communication and organizational skills with strong attention to detail.
• Self-starter with the ability to work with minimal supervision.
• Proficient PC skills including Microsoft Outlook, Word and Excel.
• Must be able to function and meet deadlines under stressful conditions and prioritize work flow.

Job Duties and Responsibilities

• Processes third party and patient refunds in adherence with company policy.
• Researches credit balance accounts for possible refund or retraction.
• Reviews incoming refund requests, via mail or fax from insurance or audit companies, for validity and responds appropriately.
• Sends any necessary adjustments, posting corrections or payment transfers to the Payment Poster Specialist.
• Coordinates refunds/retractions with third party vendors working on behalf of Halifax Health in accordance with company policy.
• Compose letters or faxes disputing refunds to insurance or audit companies.
• Call insurance companies to obtain additional information concerning the credit balance.
• Complete audits from insurance companies or internal compliance in a timely manner.
• Submits refund posting report to the Accounting department weekly.
• Responds to system tasks in a timely manner.
• Contributes to effective working relationships by demonstrating a positive and helpful attitude with co-workers.
• Maintains privacy strictly adhering to HIPAA guidelines.
• Performs other duties as assigned

We're glad you're here. As a cornerstone of our community, we need strong, compassionate and talented medical professionals just like you. Our team works together to ensure that families receive the highest-quality care in a pleasant setting where they feel valued.

Recognized as one of the 50 Top Cardiovascular Hospitals™ in the United States by IBM Watson Health™, Halifax Health serves Volusia and Flagler counties, providing a continuum of health care services through a network of organizations including a tertiary hospital, two community hospitals, urgent care clinics, psychiatric services, a cancer treatment center with five outreach locations, the area’s largest hospice, a center for inpatient rehabilitation, outpatient rehabilitation clinics, primary care walk-in clinics, a clinic specializing in women’s health, a pediatric care community clinic, five pediatric medical practices, a home health care agency and an exclusive provider organization. Halifax Health offers the area’s only Level II Trauma Center, Thrombectomy-Capable Stroke Center (TSC), Center for Transplant Services, Pediatric Intensive Care Unit, Child and Adolescent Behavioral Services, complete Neurosurgical Services, OB Emergency Department and Level III Neonatal Intensive Care Unit that cares for babies born earlier than 28 weeks.