Sr Refund Analyst at Independence Blue Cross LLC in Philadelphia, Pennsylvania

Job Description:

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Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals.  If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health.

At Independence, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve. 

Responsibilities: 

•  Process system credits on refund/returned checks for TPA claims


• •         Create refund request letters to advise providers of overpayments to initiate group credits


• •         Work together with team members on complex issues to ensure outstanding receivables are satisfied


• •         Create manual check request to reimburse providers when overpayments were previously satisfied


• •         Collaborate with Accounting and Disbursements to ensure proper GL Coding is used when issuing payments


• •         Respond to our recovery vendors timely to approve fees for overpayment recoveries


• •         The ability to multitask on email request along with projects as assigned

 

•           Minimum of 5 years’ experience in claims processing

•           Proven leadership skills

•           Knowledge of Healthrules and CFMS

•           Excellent problem-solving skills

•            Excellent organizational skills and detail oriented

•            Excellent written and verbal communication skills

•           Familiarity with ICD-10 codes, CPT-4 codes, and HCPCS codes

•           The ideal candidate will have a college degree or similar experience

 

 

Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

 

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

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