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Overprovisions Representative ID-11212

JOB DESCRIPTION OVERVIEW:

This position is responsible for reviewing/processing GE reports and correspondence in ETM system related to credit balances, refund requests, recoups, payment research, and unidentified payments for Emergency service business line. As well as handling some customer service calls from insurance companies, patients and working with Fifth Third Bank. Maintains accuracy and production. The responsibilities of the position include, but are not limited to the following:

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ESSENTIAL DUTIES AND RESPONSIBILITIES:
  • Processes guarantor, Medicare, Medicaid, Champus, Federal, and specific other situations for all groups to determine who is to be refunded.
  • Assembles appropriate documentation to validate refunds and forward to senior for approval.
  • Handles customer service calls that are transferred from NPSC or Patient Services.
  • Contacts insurance carriers/guarantors via phone call as necessary on credit balances, offsets, payment research invoices, mail correspondence, unidentified payments, and other reasons as needed.
  • Handles correspondence related to credit balances according to written procedures.
  • Processes transfer of payment.
  • Researches cancelled checks to determine if a check has been endorsed and cashed but not posted to the patient’s account.
  • Retrieves and processes NSF checks from the bank’s secured website.
  • Reports any consistent errors identified that affect accounts from being processed correctly.
  • Maintains knowledge of ETM system.
  • Processes special projects as assigned by Management.
  • Turns to supervisor or senior for unusual circumstances that may include refunds, offsets, unidentified, etc.
  • Participates in department meetings.
  • Other duties as assigned by Senior Representative, Overprovisions Supervisor and Patient Accounts Manager.

Job Requirements:

QUALIFICATIONS / EXPERIENCE:
  • High school diploma or equivalent required;
  • 6 months previous medical billing experience preferred;
  • Excellent communication skills both oral and written;
  • Proficiency in basic computer operations;
  • Must have ability to multi-task;
  • Excellent organizational skills including but not limited to general organizing, planning and time management;
  • Excellent follow-up skills;
  • Must demonstrate attention to detail;
  • Accurate 10-key by touch;
  • 40-45 WPM;
  • Saving and printing Excel spreadsheets;
  • Basic knowledge of operating office machinery;
  • Detail-oriented;
  • Effective telephone communication skills;
  • Ability to work in fast paced environment;
  • Ability to meet deadlines.
SUPERVISORY RESPONSIBILITIES:
  • None

PHYSICAL / ENVIRONMENTAL DEMANDS:

This job will be performed in a well-lighted and well-vented environment.
Work is oriented around good visual skills.
Eye fatigue may be encountered as extended amount of time is spent in front of computer display terminal.

This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions.
Also, may require physical and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.
Overtime may be required and can be mandated by Management.
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Job Snapshot

Employee Type

Full-Time

Location

Alcoa, TN (Onsite)

Job Type

Admin - Clerical

Experience

Not Specified

Date Posted

04/11/2025

 

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