Refund Adjustment Specialist I

    • Job Tracking ID: 512935-735503
    • Job Location: Meridian, ID
    • Job Level: Entry Level (less than 2 years)
    • Level of Education: High School/GED
    • Job Type: Full-Time/Regular
    • Date Updated: June 25, 2020
    • Years of Experience: Up to 2 Years
    • Starting Date: ASAP
    • Salary Type:: Hourly
    • Rate:: $12.75
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Job Description:

The Refund/Adjustment Specialist I handles voids, refunds and claim adjustments.

Key Result Areas

  • Processes adjustments in an accurate and timely manner.
  • Responds to incoming over payment inquiries.
  • Applies claim refunds.
  • Posts EFT reversals.
  • Contacts Zelis for clarification on EFT issues.
  • Generate letters to providers requesting additional monies.
  • Sends PRS Placements, applies PRS refunds.
  • Handles Stop Pays, voids, refunds, unclaimed property adjustments.
  • Processes and applies Subrogation reimbursements.
  • Processes return mail.
  • Performs other duties as assigned or needed

Experience and Skills:

  • High school degree or equivalent.
  • Knowledge of medical and dental terminology.
  • 1 - 2 year’s prior claims processing experience preferred.
  • Complete projects and tasks in a timely and accurate manner.
  • Good organizational, problem solving and analytical skills.
  • Ability to work independently.
  • Types 45 wpm, 10-key by touch, and computer knowledge.
  • Able to demonstrate excellent attendance and punctuality.
  • Excellent customer service attitude and professionalism.
  • Demonstrate Accuracy, Customer Service, Timely Turn-Around (ACT).
  • Exceptional verbal and written communication skills.
  • Proficiency using Microsoft Office (Word, Excel, Outlook, etc.).
  • Ability to work efficiently, perform multi-tasking, prioritize tasks, and meet tight deadlines.
  • Possess a high degree of integrity and discretion, as well as the ability to adhere to both company policies and best practices.
  • Ensure compliance with security practices and procedures, including HIPAA and HITRUST standards.
  • Ability to efficiently and effectively perform the Key Result Areas with or without a reasonable accommodation without posing a direct safety threat to others or self.
  • Protect and enhance the Core Purpose and the Core Values of AmeriBen.

AmeriBen is an Equal Opportunity/Affirmative Action Employer committed to creating an environment of diversity and inclusion for equal employment and advancement opportunities to all employees and applicants for employment. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, national origin, sex, sexual orientation, gender identity and/or expression, genetic information, disability, veteran or military status, or any other category protected by federal, state and/or local law.

If you are unable to use our online application process due to a disability, please contact the Human Resources Department at humanresources@ameriben.com.