Refund Escalation Specialist

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

• The Refund Escalation Specialist is responsible for the monitoring and resolving Credit balances and refunds from billing system’s overages. Daily assignments are provided by the supervisor and the Refund Escalation Specialist must develop a plan to complete work lists by the end of each day.  The Refund Escalation Specialists must comply with applicable laws regarding billing standards and be able to operate in a team-oriented environment that strives to provide superior service to our providers throughout the country.

• Processes, research, and resolves credit balances and refunds from a billing system’s overages that are escalated from the Credit team.
• Reviews refund request letters and determines an appropriate resolution based on contract and timely guidelines.
• Identifies trends and notifies appropriate departments.
• Ensure that all check registers are sent to Client Success or finance for Approval.
• Ensure we receive all check numbers from Client to be uploaded into the system to ensure Credits can be cleared.
• Ensure all returned refund checks are researched and corrected.
• Analyzes data from various reports and makes recommendations accordingly.
• Performs special projects and other duties as assigned.

• High School Diploma or Equivalent.
• Two (3) year of experience posting insurance payments in a healthcare setting.  
• Two (3) years of experience reading insurance Explanation of Benefits (EOB) statements preferred.

• Knowledge of Explanation of Benefits (EOB) statements.
• Knowledge of a variety of insurance plans.
• Strong oral, written, and interpersonal communication skills.
• Strong word processing, spreadsheet, and database software skills.
• Strong mathematical skills in addition, subtraction, multiplication and division of whole numbers and fractions; computing percentages; and working with decimal.
• Strong time management skills.
• Strong organizational skills.
• Ability to read, understand, and apply state/federal laws, regulations, and policies.
• Ability to take initiative and effectively troubleshoot while focusing on innovative solutions.
• Ability to remain flexible and work within a collaborative and fast paced environment.
• Ability to communicate with diverse personalities in a tactful, mature, and professional manner.

Equal Employment Opportunity (Applicable only in the US)
Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions.
 
Recruitment Agencies
Ventra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.
 
Solicitation of Payment
Ventra Health does not solicit payment from our applicants and candidates for consideration or placement.

Attention Candidates
Please be aware that there have been reports of individuals falsely claiming to represent Ventra Health or one of our affiliated entities Ventra Health Private Limited and Ventra Health Global Services. These scammers may attempt to conduct fake interviews, solicit personal information, and, in some cases, have sent fraudulent offer letters.
To protect yourself, verify any communication you receive by contacting us directly through our official channels. If you have any doubts, please contact us at Careers@VentraHealth.com to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on https://ventrahealth.com/careers/. 

Statement of Accessibility
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