Overprovision Representative

Posted on 2018-03-30

Job Number0066100000LdK2WAAV
Job LocationEast Tenn
Salary Range13.00/hr
PositionOverprovision Representative

Job Description

JOB DESCRIPTION OVERVIEW:

 

This position is responsible for processing credit balances, recoups, adjustments and unidentified payments for Anesthesia groups. Maintains accuracy and production.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

 

§ Processes guarantor, Medicare, Medicaid, Champus, Federal, and specific other situations for all groups to determine who is to be refunded;

§ Reviews and works all credit reports assigned within compliance guidelines;

§ Assembles appropriate documentation to validate refunds and forward to senior for approval;

§ Handles telephone inquiries regarding overprovisions;

§ Handles correspondence related to credit balances according to written procedures;

§ Contacts insurance carriers/guarantors as necessary on credit balances, offsets and unidentified payments;

§ Maintains completion of sign off logs reflecting monthly goals are being met to stay within compliance guidelines;

§ Reports any consistent errors identified that affect accounts from being processed correctly;

§ Research unidentified payments and offsets to determine the appropriate application of payments identified;

§ Responsible for maintaining all policy and procedures;

§ Turns to Supervisor for unusual circumstances that may include refunds, offsets, unidentified, etc;

§ Performs all duties as directed by management.

QUALIFICATIONS / EXPERIENCE:

 

§ High school diploma or equivalent required;

§ Previous medical billing experience preferred;

§ Excellent communication skills both oral and written;

§ Good computer skills;

§ Ability to meet deadlines;

§ Regular and predictable onsite attendance;

§ High level of interaction and teamwork.

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