Job Details
Job Location
FL - Corporate - Tampa, FL
Position Type
Practice Support
Education Level
4 Year Degree
Description
The Revenue Assurance Refund Specialist is an integral part of the revenue assurance team, your main responsibility is to review Refund Requests from office staff and insurance companies to ensure correct processes are followed prior to any refund or adjustments are approved or denied.  The selected individual will ensure policies and procedures related to account adjustments and refunds are followed, such as cash application, fee disputes, refunds/takebacks and account balance transfers. The Refund Specialist is required to ensure accurately and timely processing of refunds weekly, and ensure all documentation is accounted for prior to processing refunds. This position is accountable for achieving related operational goals for the Revenue Assurance department.
Essential Duties and Responsibilities
• Must have great attention to detail while reviewing refunds to either approve or deny requests from dental offices and insurance companies.
• Communicate and document conversations with office managers, patients and insurance representatives regarding refunds decisions.
• Read and analyze Explanation of Benefits (EOBs) and make proper adjustments according to Coast Dental Claims processing criteria.
• Identify trends on refunds requests and work with management to ensure correct processes are being followed and proper training occurs at offices.
• Maintain a high level of accuracy for any adjustments or balances entered for processing refunds after account audit has been completed.
• All refund requests must be responded to in a timely manner and any pending refunds need to be processed prior to end of month.
• Provide recommendations for improvements to business operations.
• Conduct training throughout the department, as needed.
• Other duties and special projects as assigned.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Qualifications
Knowledge, Skills and Abilities
• Must have a detailed a thorough approach to auditing accounts.
• Must have a working experience with reviewing Explanations of Benefits (EOBs).
• Experience in dental collections is preferred.
• Must be accurate, organized and detail-oriented with strong analytical and problem-solving skills.
• Strong written and verbal communication skills are required.
• Strong computer knowledge with an emphasis on MS Office suite and EagleSoft/Dentrix.
• Ability to work independently with little supervision.
Qualifications (Experience, Education, Licensure, Certification)
• Associates degree and/or equivalent experience.
• Minimum of 1 year of medical or dental insurance experience.
Working Conditions
Revenue Assurance Refund Specialist will work in areas that are highly visible and designed and furnished to make a good impression.  Most work stations are clean, well lighted, and relatively quiet.  Work is primarily sedentary in nature.