Credit Refund Representative

Job Description

Please note: this is a temporary assignment (6 months) with potential to extend.

The Credit/Refund Unit is responsible for analyzing, reviewing, and researching credit balances to determine appropriate refunds to various payees. The unit verifies the legitimacy of incoming credit and refund requests from internal and external customers and ensures the accurate processing of refunds, adjustments, and fund transfers in accordance with established guidelines, policies, procedures, and regulatory requirements.

The unit works closely with UCSF Medical Center's Accounts Payable department and affiliated institutions to ensure quality, accuracy, and compliance with UCSF, MGBS, government, and HIPAA standards.

The Credit/Refund Representative is responsible for resolving outstanding credit accounts through ongoing communication with insurance payers, other MGBS units, UCSF clinical departments, and external billing agents. The incumbent researches and resolves credit and refund discrepancies, demonstrates proficiency in all aspects of credit and refund processing, and consistently maintains high standards of accuracy, quality, customer service, and regulatory compliance.

Qualifications

Required: - Minimum of 2-3 years of experience in a hospital or physician billing office, or an equivalent combination of education, training, and experience. - Flexibility to orient and work at all UCSF Medical Center locations. - Knowledge of CPT and ICD-9 or ICD-10 coding. - Experience with denials management and all aspects of billing and follow-up. - Proficiency in Microsoft Excel and Outlook. - Strong organizational, interpersonal, verbal, and written communication skills. - Ability to work effectively in a changing environment while managing multiple priorities and tasks. - Demonstrated time management skills, including the ability to prioritize assignments and meet deadlines. - Ability to work independently and collaboratively as part of a team. - Ability to consistently meet productivity and quality standards. - Strong customer service skills and a positive, professional attitude. - Demonstrated ability to coach and mentor staff to achieve optimal results. - Ability to establish priorities, goals, and objectives. - Excellent attendance and reliability. Preferred: - Prior experience with the EPIC (APeX) system. - Certified Professional Coder (CPC) credential. - Associate's or bachelor's degree.