Refund Specialist

About Ventra Health

Ventra Health is a leading provider of business solutions tailored for facility-based physicians in anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Specializing in Revenue Cycle Management, Ventra collaborates with private practices, hospitals, health systems, and ambulatory surgery centers to offer transparent, data-driven services that address complex revenue and reimbursement challenges, allowing clinicians to concentrate on delivering exceptional patient care.

Role Summary

The Refund Specialist is responsible for monitoring, researching, and processing patient and insurance refunds accurately and timely.

Key Responsibilities

• Manage credit balances and refunds by investigating overpayments within the billing system.
• Assess refund requests and determine resolution in line with contracts and applicable timelines.
• Identify recurring refund trends and communicate relevant information to other departments.
• Use online portals to retrieve Explanation of Benefits (EOB) documents.
• Engage with insurance providers to verify refund details and confirm accuracy.
• Analyze data from various reports to propose recommendations and improvements.
• Undertake special projects and additional tasks assigned by supervisors.

Qualifications and Experience

• High school diploma or equivalent educational qualification.
• At least two years of experience posting insurance payments in a healthcare environment.
• Preferred: Two years of familiarity with interpreting insurance Explanation of Benefits (EOB) statements.

Skills and Abilities

• Understanding of Explanation of Benefits (EOB) statements and diverse insurance plans.
• Clear and effective oral, written, and interpersonal communication capabilities.
• Proficiency in word processing, spreadsheets, and database management software.
• Strong numerical aptitude including addition, subtraction, multiplication, division, percentage calculations, and working with decimals and fractions.
• Excellent organizational and time management skills.
• Capability to interpret and apply relevant state and federal laws, regulations, and policies.
• Demonstrated initiative and problem-solving skills aimed at innovative solutions.
• Adaptability to fast-paced, team-oriented work environments.
• Professional and tactful communication with diverse individuals.

Compensation

The base salary will be determined based on the candidate's location, experience, skills, and qualifications. Additionally, this role qualifies for a discretionary performance incentive as part of Ventra's reward programs.

Additional Information

• The position participates in Ventra's Reward & Recognition initiatives including performance incentives and referral bonuses.
• Ventra Health is committed to equal employment opportunities, promoting diversity, inclusiveness, and providing accommodation for qualified individuals with disabilities.
• Recruitment agencies are not accepted; unsolicited resumes will not be entertained.
• Candidates should be cautious of fraudulent communications pretending to represent Ventra Health; direct verification through official channels is advised.
• Ventra maintains an accessibility statement to ensure digital inclusiveness, continually improving user experience.