The Refunds and Financial Advisor Specialist supports SEES Management, LLC’s goals, values and philosophy by exhibiting the following behaviors: excellence, quality service, commitment and accountability. As a member of the SEES Management, LLC team, performance includes demonstration of the following accountabilities: communication, teamwork and job knowledge.
POSITION SUMMARY
The Refunds and Financial Advisor Specialist is responsible for all facets of coordination of refunds to patients and payers across the enterprise. The primary duties include but are not limited to verification of credit balances on patient accounts, research to ensure other patient balances are not due and owing to other Company entities, transfer of credit balance among or between Company entities when applicable, and processing refunds involved in cases that are co-managed by outside optometrists. Additionally, the Refunds and Financial Advisor Specialist will be familiar with all financial assistance and payment arrangement options offered by SEES Management, LLC and will be responsible for gathering application information from patients who require such assistance and either approving requests for financial assistance based upon established criteria or escalating these requests to the appropriate Manager. Refunds and Financial Advisor Specialists shall be responsible for producing monthly reports showing activities and outcomes so that trends may be monitored appropriately. In addition, Refunds and Financial Advisor shall be cross-trained in other functions of revenue cycle responsibilities, including processing charges, posting payments, following up on unpaid balances (current and in collections), and answering patient questions regarding their balances.
ESSENTIAL FUNCTIONS include the following:
• Reviews and investigates monthly credit balance reports and determines if a refund is due to a patient or insurer
• Processes refunds to patients or insurers appropriately, or assists in the determination of when a credit balance transfer should occur between SEES Management, LLC entities
• Processes monthly co-management reports so that appropriate entries are made in patient accounting system prior to co-management payment being issue to external co-managing physicians.
• Provides reports to management regarding refund or credit balance activity to ensure accounting and compliance standards are met
• Research unidentified cash and returned checks for processing
• Identify Payment Posting/Processing Issues and communicate trends and findings.
• Processes, posts and credit balance payments when transferred between or among company entities
• Completes monthly escheat documentation and files Unclaimed Property Report with each state in which SEES Management, LLC is conducting business
• Review and processes applications for Financial Assistance according to approval guidelines
• Escalates Financial Assistance applications according to pre-defined criteria
• Provides monthly reports regarding Financial Assistance applications so that trends may be identified
• Troubleshoots and resolves issues with any of the patient billing processes within scope of job functions.
• Maintains confidentiality of patient and company information.
• Maintains knowledge of and follows policies, procedures, Code of Conduct, and all Federal and state rules and regulations related to the position.
• Reacts positively to change.
• Completes all required compliance training.
• Duties and responsibilities may be added, deleted, or changed at any time at the discretion of management, formally or informally, either verbally or in writing.
SUPERVISORY RESPONSIBILITIES
None
KNOWLEDGE, SKILLS, & ABILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Familiarity with deductibles, contractual adjustment, insurance plans, and procedures
• Good problem solving and analytical skills
• Understanding of cash processing transactions, including payment and adjustment posting
• Understanding of remittances reason and remark codes
• Detail oriented with strong organizational and follow-up skills
• Strong interpersonal and customer service skills
• Strong computer skills
• Ability to adapt to changing insurance regulations
• Ability to discuss collections with patients in a confident manner
• Ability to speak, read, and write in English
• Ability to effectively communicate both orally and in writing
• Ability to operate standard office equipment
• Ability to concentrate, think, and learn
• Ability to hear, see, sit, stoop, kneel, crouch, reach, lift, push, and pull.
EDUCATION AND/OR EXPERIENCE
High School diploma or equivalent is required; a minimum of one (1) year experience in medical billing and collections or cash management in a healthcare setting is preferred; medical insurance knowledge is required; and/or equivalent education or experience in job related activities is required.
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