Refund Coordinator PBO

Penn Medicine, University of Pennsylvania Health System; Bala Cynwyd (PA); Hybrid; USD 60,000 - 85,000; Full time

Job summary

Penn Medicine, located in Bala Cynwyd, PA, seeks a Refund Coordinator to monitor insurance and patient credit balances across primary and specialty practices. You will generate departmental reports, investigate discrepancies, and ensure timely refund processing.

The role requires strong data entry, attention to detail, and proficiency with Epic APM. You will work within the Physician Billing Office in a hybrid setting, supporting end-to-end credit resolution workflows across multiple clinics.

Qualifications

• High School Diploma or GED required.
• 4+ years of related experience required.
• Bachelor's degree preferred.

Responsibilities

• Processing refunds using department reports and work queues.
• Researching credits in Epic and patient accounts; gathering supporting documentation.
• Posting refund entries and monitoring credit balances to zero.
• Handling inter-entity refunds and adjusting accounts as needed.
• Providing workflow support for credit resolution and related processes.

Skills

Data entry

Refund processing

Epic APM

Education

High School Diploma

Bachelor's degree preferred

Tools

Epic APM

Job description

Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Entity: Corporate Services

Department: Physician Billing Office

Hours: M-F, 8 hr days

Location: Bala Cynwyd, PA/hybrid

Summary

• The Refund Coordinator monitors insurance and patient credit balances for over 200 Penn Primary Care and Penn Specialty Care practices. The coordinator produces and distributes department work queue trending reports for 14 work queues to capture outstanding patient credit balances and assists in managing department AR reps to ensure accurate and timely review and credit resolution activities. The coordinator each department's copay credit work queue balances and provides feedback to the departments for credit evaluation and resolution while processing patient insurance refunds and monitoring patient credit work queue trends. The refund coordinator produces and maintains insurance credit trending reports for all PPC/PSP practices: > 200 practices and 300 clinicians. The coordinator is responsible to apply a series of strategies to ensure credit thresholds are maintained for all credit balances posted against CCA/CHCA entity practices. The coordinator is also responsible for end user payor portal provisioning and log in support. The refund coordinator assists in investigating and escalating Trust Commerce related issues and inquiries. The coordinator provides workflow support to Revenue Cycle users for all credit resolution workflows, insufficient funds workflows, and paid not posted workflows.

Responsibilities

Processing Refunds

• Utilizes reports and work queues to identify and research credits
• Researches transactions in Epic, analyze patient accounts
• Gathers supporting documentation utilizing various systems and resources to interpret and verify the legitimacy of all credit balances.
• Data Entry - Approve refund requests after review in Epic APM
• Monitors Approved Refund Request report and payment and refund report to identify discrepancies or system issues
• Processes all refund requests from practices in timely manner
• Forwards completed request, assembled with supporting documentation to PBO
• Posts refund debit code, to bring account to zero balance

Account Resolution

• Resolves problems with patient accounts resulting in credit balances from prepayments, overpayments or payment posting errors in systems
• Moves Self Pay credit balance to any Self Pay open invoices
• Processes group to group transfer - Facilitate transfer of PB/HB or HB/PB credits to debit balances by reviewing for appropriateness and submitting the request to the appropriate resource to complete the transfer request.
• Processes fund transfers in system as appropriate
• Forwards documentation for inter-entity refunds

Other Duties

• Investigates and processes all void checks and documents reason for void check
• Notifies Supervisor of non-compliance issues and unusual activity
• Reviews work queue activity and follows procedure for posting unidentified cash to appropriate accounts
• Monitors Paid Not Posted workqueue and assists in researching payments and resolving accounts
• Handles non-patient revenue issues
• Works refund projects and other special projects as assigned - Leads Revenue Cycle team dedicated credit resolution sessions - Works with Revenue Cycle team resources to assign insurance credit resolution related goals, projects, and objectives - Presents Revenue Cycle credit trending in workshops and department meetings - Mentors Revenue Cycle for credit resolution related workflows and projects - Investigate and elevate, as needed, any Trust commerce related issues or inquiries - Support end user provisioning for payer portals for new practice implementations.
• Performs duties in accordance with Penn Medicine and entity values, policies, and procedures.
• Other duties as assigned to support the unit, department, entity, and health system organization.

Education or Equivalent Experience

• High School Diploma/GED is required.
• 4+ years of related experience is required.
• Bachelor's degree is preferred.

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.