Revenue Cycle Credit & Refund Specialist
River Edge, NJ
MAX Main Office – Revenue Cycle Management /
Full-time /
Hybrid
$27 - $33 an hour
Join MAX Surgical Specialty Management, an innovative leader in the healthcare industry, as we embark on an exhilarating journey of growth and expansion! We are seeking a motivated and dynamic individual to join our Revenue Cycle Management Team as a Revenue Cycle Credit & Refund Specialist.
What You'll Do:
The Revenue Cycle Credit & Refund Specialist will be responsible for evaluating all accounts with credit balances and performing processes needed to resolve them. The primary responsibility of this position is account resolution which includes the following duties: reviewing accounts with credit balances, validating the overpayment is correct, posting refund adjustment, and processing refunds out to the patient and/or insurance carrier.
The successful candidate will be able to:
·Evaluate accounts with credit balances and perform processes needed to resolve them, including
researching if the balance is owed and who it is owed to
·Investigate insurance overpayment, offset correspondence and take appropriate action for resolution
·Handle patient phone inquiries regarding refunds
·Process refunds due to pre-payment
·Process mail returns on refund checks
·Process unclaimed property credits
·Evaluate refund requests from various payors and determine proper action
·Work credits & refund balances ensuring that refunds are processed within 30 days from eligibility date
·Take other steps to move account balances to resolution (e.g. set to bill to patient)
·Read and analyze insurance Explanation of Benefits (EOB) and discounts to validate refund amount
·Review letters from insurance companies requesting refunds and issue due refunds as necessary
·Research and navigate insurance policies, benefits, and exclusions to provide accurate information to
patients & management team
·Utilize phone etiquette to communicate effectively with patients regarding their refunds
·Demonstrate a professional image in dealing with the public, patients, clinical offices, and insurance
carriers
·Prepare Refund Request files and supporting documentation regarding overpayment calculations to submit
to accounting
·Submit corrected claims or appeals to insurance carriers for both Medical & Dental
·Perform appropriate adjustments when required
·Maintain working knowledge of the Billing Office policies and procedures for accurate handling of patient
accounts
·Perform any and all other duties as assigned
What You’ll Bring:
-High School Diploma, Medical Billing and/or Coding Certification highly preferred, but not required
-3+ years of hands-on experience in healthcare revenue cycle management, with a proven track record of
optimizing processes
-Revenue cycle experience in payment posting & insurance is a MUST
·Proficient in all Microsoft Office applications as well as medical office software
·High level of mathematical/analytical aptitude, attention to detail, and strong communication skills
·Proven experience in healthcare billing
·Sound knowledge of health insurance providers
·Strong interpersonal and organizational skills
·Excellent customer service skills
·The ability to work in a fast-paced environment
Perks of the Job:
-Highly competitive salaries & annual performance and compensation reviews
-Competitive health insurance and benefits, including medical, dental, vision, disability, and more
-401k retirement savings plan that includes employer match
-Generous Paid Time Off, sick leave, and paid holidays
-Advance your career growth with opportunities in the most extensive growing oral surgery practice in the Northeast
About MAX Surgical Specialty Management:
Established in September 2022 as the Northeast region’s first oral and maxillofacial surgery-only specialty platform, MAX Surgical Specialty Management is a surgeon-led management services organization developed with clinical and surgeon autonomy at its core. Today, MAX supports surgeons across New Jersey, New York, Pennsylvania, Vermont and Connecticut, enabling practices to channel resources, skills and knowledge within the oral surgery specialty, leading industry advancements and delivering the highest standard of patient care. Surgeons have access to a curated network that allows them to collaborate with and work alongside a diverse pool of highly skilled peers who are leaders in their specialty. MAX safeguards surgeons’ independence while offering robust support systems, access to advanced technology and opportunities for financial growth.
Integrity-driven. Patient-focused. Experience the difference at www.max-ssm.com.
MAX Surgical Specialty Management is an equal opportunity employer committed to providing fair employment opportunities regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, marital status, veteran status, or any other legally protected characteristic. We welcome diversity and encourage applicants from all backgrounds. Our inclusive environment values and empowers every employee to contribute to our mission.
