Refund/Credit Specialist

Fred Hutchinson Cancer Center is an independent, nonprofit organization providing adult cancer treatment and groundbreaking research focused on cancer and infectious diseases. Based in Seattle, Fred Hutch is the only National Cancer Institute-designated cancer center in Washington.

With a track record of global leadership in bone marrow transplantation, HIV/AIDS prevention, immunotherapy and COVID-19 vaccines, Fred Hutch has earned a reputation as one of the world's leading cancer, infectious disease and biomedical research centers. Fred Hutch operates eight clinical care sites that provide medical oncology, infusion, radiation, proton therapy and related services, and network affiliations with hospitals in five states. Together, our fully integrated research and clinical care teams seek to discover new cures to the world's deadliest diseases and make life beyond cancer a reality.

At Fred Hutch we value collaboration, compassion, determination, excellence, innovation, integrity and respect. These values are grounded in and expressed through the principles of diversity, equity and inclusion. Our mission is directly tied to the humanity, dignity and inherent value of each employee, patient, community member and supporter. Our commitment to learning across our differences and similarities make us stronger. We seek employees who bring different and innovative ways of seeing the world and solving problems. Fred Hutch is in pursuit of becoming an anti-racist organization. We are committed to ensuring that all candidates hired share our commitment to diversity, anti-racism and inclusion.

The Refund/Credit Specialist is responsible for the daily review and identifying of credits for Commercial Insurance and Patient Payments for resolution. This process is in combination of reviewing patient accounts, insurance payment remits, insurance refund request letters and patient refund requests.

Investigate insurance and patient overpayments to determine proper resolution which could include refund, redistribution of funds or adjustment.
• Analyze, research and answer refund questions.
• Ensure correct reimbursement rates are reflected before refunding insurance overpayments.
• Review insurance request letters daily and forwarding qualifying letters to Payer Audit Analyst for review.
• Identify insurance refund requests that are for Government payers and forward to Government Follow-up team for review.
• Work with Case Rate team to refund commercial payments incorrectly paid on Transplant claims.
• Review credits in work queues.
• Identify patient overpayments and process refunds with appropriate backup within 90 days of posting to account.
• Use insurance Explanation of Benefits to determine payment and contractual adjustment for Hospital Account Record (HAR) corrections.
• Identity overpayments and process refunds to commercial insurance payers through payer portals or check request.
• Use insurance payer portal to obtain explanation of benefits to verify balances.
• Track trends from insurance requests and bring visible for discussion with team and Supervisor.
• Contact insurance companies to validate or dispute refund requests.
• Maintain open communication with Accounts payable team for Void Check / Stop Pay requests for returned checks from insurance and patients.
• Collaborate with other internal teams to resolve credit balances.
• Maintain knowledge of contracted insurance expected reimbursement rates and timely overpayment refund guidelines.
• Perform other duties as assigned.

Required:

• High school graduate or equivalent.
• One year of revenue experience.
• Understanding of debits and credits.
• Ability to read/understand explanation of benefits (EOB).
• Ability to use a computer keyboard and mouse, navigate computer programs, and use email in a business setting.
• Ability to communicate verbally in person, on the phone, and in writing in a clear and concise manner.
• Strong problem solving and researching skills.

Preferred:

• Experience in a Hospital Account Follow-up position.
• Customer Service background working in a Hospital Revenue Cycle setting.
• Knowledge of Medicare CMS guidelines and PPO Exempt regulations for reviewing Medicare Advantage programs.

A statement describing your commitment and contributions toward greater diversity, equity, inclusion, and antiracism in your career or that will be made through your work at Fred Hutch is requested of all finalists.

The hourly pay range for this position is from $25.22 to $35.90 and pay offered will be based on experience and qualifications.

Fred Hutchinson Cancer Center offers employees a comprehensive benefits package designed to enhance health, well-being, and financial security. Benefits include medical/vision, dental, flexible spending accounts, life, disability, retirement, family life support, employee assistance program, onsite health clinic, tuition reimbursement, paid vacation (12-22 days per year), paid sick leave (12-25 days per year), paid holidays (13 days per year), paid parental leave (up to 4 weeks), and partially paid sabbatical leave (up to 6 months).