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Refund Specialist Resume Example

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REFUND SPECIALIST
Summary
Looking to become a valuable asset to a company utilizing my knowledge of medical billing, my business and customer service skills. I am a dedicated team player, i provide excellent customer service via verbal and written communication to both clients and mangement. Eager to learn, fast learner, adept at working under pressure and working to meet deadlines. Experienced in resolving complex problems for cases and situations requiring special attention and quick resolution.
Skills
Typing 40+ wpm, 10 key by touch, working knowdge of Windows as well as Microsoft Office, Freeview & Perceptive Content 7(content management programs), Citrix, Vision, Epic, WebPT, AdvancedMD, DDE (MCR), Acryness, Skip Jack, NextGen, Realmed/Avality, Centricty EMR.
Experience
02/2014 to 02/2016
Refund Specialist Med3000/McKesson/ChangeHealthcare － Oldsmar, FL
  • Responsible for auditing out patient accounts for serverel different clients/client types, to validate whether the credit located on the paitents account belongs to the patient or the insurance company.
  • its my responsibility to pull the EOBs to make sure all the insurance adjustments and payments where posted correctly per the EOB or the patients statement.
  • If the payment was posted incorrectly its my reposibility correct the posting error.
  • If the credit is a legitimate refund I whould prepare refund request to be sent to the client to cut a check for either the insurance company or the patient with all the pertinent backup.
02/2007 to 01/2010
Payment Posting Med3000/McKesson/Change Healthcare － Oldsmar, FL
  • My resposibilities include acccurately applying insurance and patient payments/adjustments according to insurance EOB/customer statment, reviewing and correcting electronically posted payments, assiting in processing both insurance and patient refunds as needed and reviewing accounts and correcting posting errors for several different clients.
02/2010 to 02/2014
Payment Posting Team Lead Med3000/Mckesson/ChangeHealthcare － Oldsmar, FL
payment Posting Team Lead/ Acting Supervisor
  • In addition to my reponsibilities as a payment poster i also was responsible for balancing the cash logs for several clients on a daily basis, assinging work such as payment batches/payment posting error correction request.
  • Resposible for reporting the daily finincials and daily production for 20+ employees,running and reporting of specialized programs such as small balance adjustments wite off, and the credit match programs.
  • I was given the resposibility of changeing users abbilities within the system as needed.
  • I was also resposible for answering any policy and procedure questiong for cash posting for several differnt clients, as well as educating employees on how to read and process the more difficult EOB's.
06/2015 to Current
Data Integreitry Associate Med3000/McKesson.com/ChangeHealthcare － Oldsmar, FL
  • Its my resposibility to audit the accounts our over seas as well as on shore team have processed.
  • If i am auditing a refunds i'm making sure its a legitiemate refund, making sure the paymnets and adjusments were posted correctly, if its a refund i make sure the refund forms are filled out correctly and make sure all the pertinent back up that is required is with the refund.
  • if its a posting error i make sure a correction form has been filled out correctly, has the required backup attahced and is sent to the appropriate department to correct the error.
  • If im am auditing A/R i look at the notes on the account to verify the rep noted the account and and to verify what action was taken per the action codes and the notes, I make sure they have done what the note states such as rebilling a corrected claim, making sure medical records were sent to in ins company, ailment or modifiers were corrected and make sure it was done correctly.
  • In my addtiion to being an auditor i also have daily training call with our over seas associates training them on how to process a refund, locate eobs, how to read eobs, how to identify a posting errors, how to correct any posting errors, how fill out the refund forms for both insurance and patient refunds, advising what information is required to process a refund properly, I also provided them with refund manuals created by me and another associate, i also comunicate daily with our over seas associates answering any question they may have.
  • I also had to do a fucus audit weekly on our over seas associates and provided feedback daily to management on their progress.
Skills
10 key by touch, auditing, backup, balance, Citrix, content management, Content 7, credit, client, clients, forms, insurance, notes, Microsoft Office, Windows, progress, read, reporting, Typing, Vision
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Resume Overview

Companies Worked For:

  • Med3000/McKesson/ChangeHealthcare
  • Med3000/McKesson/Change Healthcare
  • Med3000/Mckesson/ChangeHealthcare
  • Med3000/McKesson.com/ChangeHealthcare

Job Titles Held:

  • Refund Specialist
  • Payment Posting
  • Payment Posting Team Lead
  • payment Posting Team Lead/ Acting Supervisor
  • Data Integreitry Associate

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