REFUND ANALYST

Talentify; Rancho Cordova (CA); On-site; USD 48,000 - 64,000; Full time

Job summary

Dignity Health Medical Foundation in California is seeking a Refund Analyst to research and resolve outstanding credit balances in alignment with the organization’s mission. You will work under the A/R Billing Supervisor, handling complex payor rules, contract language, DOFR interpretations, and posting payments accurately.

The role requires at least 1 year in medical billing, strong math skills, and proficiency with MS Word and Excel.

Qualifications

• High School Diploma or GED.
• 1 year experience in professional medical billing office.
• Proficiency in MS Word and Excel.
• Knowledge of contract adjustments, deductibles, denial types and other messages on third party documentation, including EOBs.
• High level of math ability and 10 key experience.
• Working knowledge of computers and demonstrated proficiency in using Email systems and Internet.

Responsibilities

• Demonstrate a solid understanding of accounts receivable and your role as a Refunds Analyst: Payor Rules & Regulations, Understanding contract language, CCI Coding Issues, Read and interpret DOFR, Comprehend how transactions affect account, Coordination of Benefits rules, Offsets / Takebacks, Payment Posting
• Ability to determine correct systems to locate pertinent info: IDX, MPV, Medical Records Systems, Insurance Payor Web Sites, Code Correct Web Site
• Ability to manage multiple expectations, tasks and deadlines effectively
• Timely review of electronic communication to stay informed of changes that affect your position
• Proactively organize and manage case load to ensure refunds are completed timely to avoid offsets
• Ability to independently research and resolve intermediate to complex issues with available resources and tools

Skills

Research and problem solving

Multi-tasking

MS Office proficiency

Education

High School Diploma or GED

Tools

IDX

MPV

Medical Records Systems

Insurance Payor Web Sites

Code Correct Web Site

Job description

Where You'll Work

Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California, Arizona and Nevada. Today, Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers, we provide increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled, qualities that are vital to maintaining excellence in care and service.

Job Summary and Responsibilities

Under the direction of the A/R Billing Supervisor, the Refund Analyst is responsible for researching and resolving all outstanding credit balances consistent with the Mission and Philosophy of Dignity Health Medical Foundation.

• Demonstrate a solid understanding of accounts receivable and your role as a Refunds Analyst: Payor Rules & Regulations, Understanding contract language, CCI Coding Issues, Read and interpret DOFR, Comprehend how transactions affect account, Coordination of Benefits rules, Offsets / Takebacks, Payment Posting
• Ability to determine correct systems to locate pertinent info: IDX, MPV, Medical Records Systems, Insurance Payor Web Sites, Code Correct Web Site
• Ability to manage multiple expectations, tasks and deadlines effectively
• Timely review of electronic communication to stay informed of changes that affect your position
• Proactively organize and manage case load to ensure refunds are completed timely to avoid offsets
• Ability to independently research and resolve intermediate to complex issues with available resources and tools

Job Requirements Required

• High School Diploma or GED
• 1 year experience in professional medical billing office
• Demonstrated proficiency in MS office software applications with emphasis in Word and Excel
• Knowledge of contract adjustments, deductibles, denial types and other messages on third party documentation, including EOB's
• High level of math ability and 10 key experience
• Working knowledge of computers and demonstrated proficiency in using Email systems and Internet