Navigant Consulting Inc Refund Representative- Navigant- Birmingham, AL in Birmingham, Alabama

Navigant Consulting, Inc. (NYSE: NCI) is a specialized, global professional services firm that helps clients take control of their future. Navigant’s professionals apply deep industry knowledge, substantive technical expertise, and an enterprising approach to help clients build, manage and/or protect their business interests. With a focus on markets and clients facing transformational change and significant regulatory or legal pressures, the Firm primarily serves clients in the healthcare, energy and financial services industries. Across a range of advisory, consulting, outsourcing, and technology/analytics services, Navigant’s practitioners bring sharp insight that pinpoints opportunities and delivers powerful results. More information about Navigant can be found at navigant.com.

Navigant Cymetrix unites the strengths of four category-leading companies to address the complexities of today’s healthcare system. We design, develop and implement integrated, patient-centered solutions for sustained improvements in performance and profitability, working collaboratively across a spectrum of customers that encompasses hospitals, health systems, physician practice groups and payers.

The Refund Representative, under general supervision and according to established policies and procedures, performs a variety of duties related to processing of overpayments made to the Management Services Organization (MSO). Such duties may include, but are not limited to; processes overpayment requests, post contractual adjustments, write offs, or transfers accordingly to resolve credit balances, resubmits claims and supporting documentation as needed, and communicates with third party payers in response to overpayment request and/or to obtain insurance hierarchy information. Communicates issues to management timely. Performs other duties as assigned by direct supervisors.

  • Must be self-directed / self-motivated; must have good communication and interpersonal skills.

  • Perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure.

  • Accept responsibility for one’s own work; works independently.

  • Recognize the rights and responsibilities of patient confidentiality.

  • Convey empathy and compassion to those experiencing pain, physical or emotional distress and/or grief.

  • Relate to others in a manner which creates a sense of teamwork and cooperation.

  • Communicate effectively with people from every socioeconomic, cultural and educational background.

  • Exhibit flexibility and cope effectively in an ever-changing, fast-paced healthcare environment.

  • Perform effectively when confronted with emergency, critical, unusual or dangerous situations.

  • Demonstrate the quality work ethic of doing the right thing the right way.

  • Maintain a customer focus and strive to satisfy the customer's perceived needs.

  • Analyze credit balance invoices for resolution.

  • Analyze insurance and patient overpayments for resolution.

  • Update patient insurance information and file claims as necessary.

  • Works refund requests received from third party payers, other departments.

  • Processes various reports pertaining to credit balances.

  • Key transactions necessary to resolve credit balance.

  • If no refund due, post appropriate adjustment or transfer.

  • If refund due, post in AES, batch and submit to supervisor for processing or approval.

  • Key insurance refunds on-line to appropriate payers as necessary.

  • Balance all refund batches daily and submit to Supervisor for processing.

  • Other duties as assigned by management.

  • High school diploma or equivalent.

  • CPC preferred.

  • Two years of related experience and general knowledge of payer-specific or medical specialty billing.

  • Knowledge of CPT and ICD-9 coding.

  • Good written and verbal communication skills.

  • Basic computer skills.

  • Strong conceptual, as well as quantitative and qualitative analytical skills

  • Work as a member of a team as well as be a self-motivator with ability to work independently

  • Constantly operates a computer and other office equipment to coordinate work

  • Regularly uses close visual acuity and operates computer equipment to prepare and analyze and transmit data

  • Generally works in an office environment

Navigant Cymetrix is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information or any other basis protected by law, ordinance, or regulation.

Navigant will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.