You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

We are seeking a diligent Refund Specialist for our client. The role involves accurately appealing and responding to payor refund requests, reviewing EOBs, ensuring correct application of adjustments and payments, and familiarizing oneself with billing policies to construct valid arguments against refund requests.

Responsibilities / Job Duties

• Accurately appeals and responds to incoming payor refund requests based on set internal guidelines.
• Review EOBs and ensure allowances, adjustments, unallocated payments, and overpayments are applied properly in the system.
• Become familiar with necessary tests, billing policies, and fee schedule to construct valid arguments to overturn refund requests.
• Creates notes in the system documenting all actions taken on each account.
• Comply with state/federal regulations and adhere to HIPAA and PHI guidelines.
• Maintains a refund tracking spreadsheet for all refund requests and follows up if further action is required.

Minimum Education and Experience Qualification Requirements

Qualifications

• 2+ years of refund/recoupment experience
• Ability and willingness to appeal refunds from payors
• Preferred Lab/Xifin experience
• Preferred experience with appeals specifically around refunds

Schedule / Shift

Can start as early as 6am PST - 8-hour shift - must be consistent in start time and working hours. Training will be starting between 6am-7am PST, and then hours can flex up to 8am PST after getting established.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

As an Equal Opportunity Employer, we value all our employees' diverse backgrounds, experiences, and skills. We are committed to crafting a fair and inclusive environment that doesn't discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.