Refund Specialist

About Us

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.

Come Join Our Team!

• As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewards

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Job Summary

• The Refund Specialist is primarily responsible for monitoring and issuing patient and insurance refunds.

Essential Functions and Tasks

• Processes, researches and resolves credit balances and refunds from a billing system’s overages.
• Reviews refund request letters and determines an appropriate resolution based on contract and timely guidelines.
• Identifies trends and notifies appropriate departments.
• Navigates websites to obtain Explanation of Benefits (EOB).
• Contact insurance carriers to verify possible refund details.
• Analyzes data from various reports and makes recommendations accordingly.
• Performs special projects and other duties as assigned.

Education and Experience Requirements

• High School Diploma or Equivalent.
• Two (2) year of experience posting insurance payments in a healthcare setting.  
• Two (2) years of experience reading insurance Explanation of Benefits (EOB) statements preferred.

Knowledge, Skills, and Abilities

• 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.

Compensation

• Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons. 

• This position is also eligible for a discretionary incentive bonus in accordance with company policies. 

Ventra Health

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 AgenciesVentra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes. Solicitation of PaymentVentra Health does not solicit payment from our applicants and candidates for consideration or placement.

Attention CandidatesPlease 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 [email protected] to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on https://ventrahealth.com/careers/. 

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