CBO Refund Analyst

Job Description

JOB DETAILS

REQUIREMENTS

• A high school diploma or equivalent is required.
• Minimum of one year of relevant experience and/or training preferred.
• A comparable combination of education and experience will also be considered.

RESPONSIBILITIES

• Review and work Credit Balance Reports by provider group/Work Queue daily
• Prepare refund letters with supporting EOBs/documentation; save to designated folder for mailing with refund checks
• Document accounts with refund reasons and apply correct Kickcodes when needed
• Open cases for posting errors; pend claims until resolved
• Report posting errors to Directors for correction
• Follow up on unresolved cases older than 10 days
• Use payer websites for updated refund policies and overpayment forms
• Send Overpayment Letters with EOBs to insurers to determine if overpayments can be recouped from future remits
• Adjust credit balances for all carriers (except Government) with the correct adjustment code when OPL letters are sent
• For Government carriers, apply the correct Kickcode once OPL letters are sent
• Work all correspondence within 7 days of receipt
• Maintain productivity standards: 5 claims per hour / 40 accounts per day
• Meet established performance goals within 90 days of employment

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