Recoupment Representative, Client Financial Services

Job Description:

Job Title: Recoupment Representative

Location: Springfield, Missouri

Department: Client Financial Services

Employment Type: Full-Time

Shift: Mon-Fri 8am-5pm

Job Summary:

Are you a passionate and dedicated professional looking to make a positive impact in the financial operations of our healthcare organization? Do you want to work in a supportive and dynamic environment where you can grow your skills and advance your career? Join our team as a Recoupment Representative, Client Financial Services!

As a Recoupment Representative, Client Financial Services, you'll review and process insurance overpayment requests, insurance credit balances, compliance audit repayments, and client credit balances. You'll collaborate and work with team members throughout the system to recover funds. Our ideal candidate is passionate about financial services in healthcare, has experience in billing, collections, or payment processing, and strong analytical and communication skills.

Springfield, Missouri offers a high quality of life, with a vibrant community, affordable cost of living, and beautiful natural surroundings. Join us in ensuring financial excellence and advancing your career!

Position Perks & Benefits:

• Employee benefits package - health, dental, vision, retirement, life, & more

• Paid time off - 29 days per year including vacation & holiday pay

• Mileage reimbursement - company paid for work functions requiring travel

• Top-notch training - initial, ongoing, comprehensive, and supportive

• Career mobility - advancement opportunities/promoting from within

• Welcoming, warm, supportive - a work culture & environment that promotes your well-being, values you as human being, and encourages your health and happiness

Key Responsibilities:

• Collaborate with the Compliance department to manage audit repayments and ensure thorough tracking for completeness.

• Analyze accounts receivable balances to identify and address insurance credit balances requiring resolution or repayment.

• Assess client payment credit balances on accounts and take necessary actions for resolution or repayment.

• Prepare refund request forms and compile supporting documentation for submission to the Accounts Payable department for repayment or initiate recoupment processes.

• Assist Compliance in repayment of services identified within an internal audit review for federally funded payers.

• Initiate and release guarantor holds in the electronic health system for client charts where an internal audit is being conducted.

• Review and validate insurance overpayment letters for federal and non-federal payers.

• Dispute requests for overpayment as necessary.

• Address client credit balances and review services for insurance payer credit balances.

• Respond promptly to phone calls or emails regarding credit balance resolution or refunds.

• Process check refund requests with proper documentation in the electronic health system.

• Monitor and initiate voided claims, following through to recoupment.

• Document workflows.

• Perform other duties as needed.

Education and/or Experience Qualifications:

• High school diploma or General Educational Diploma (GED) is required.

• Preferably certified in Billing and/or Coding.

• At least two years of experience in a healthcare setting, with a focus on billing, collections, payment processing, or denial management.

• Experience with Missouri Certified Community Behavioral Health Organization (CCBHO) and managed care organization (MCO) billing is advantageous.

Additional Qualifications:

• Strong data analysis skills, especially with system reports.

• Proactive problem-solving and ability to implement solutions independently.

• Proficient in reading and following policies and procedures.

• Effective time management and multitasking under deadlines.

• Excellent verbal and written communication skills.

• Comfortable and proficient with computer systems, including Microsoft Word and Excel.

• Ability to securely handle confidential information.

• Experience documenting processes.

• Detail-oriented with strong prioritization skills.

• Accurate data entry and 10-key proficiency.

• Ability to work independently and collaboratively in a positive manner.

• Familiarity with insurance portals and medical terminology preferred.

Brightli is on a Mission:

A mission to improve client care, reduce the financial burden of community mental health centers by sharing resources, a mission to have a larger voice in advocacy to increase access to mental health and substance use care in our communities, and a mission to evolve the behavioral health industry to better meet the needs of our clients.

As a behavioral and community mental health provider, we value diversity, equity, and inclusion in our workforce and encourage applications from individuals from diverse backgrounds and experiences. If you are passionate about empowering your local communities and promoting health equity, we invite you to join our mission-driven organization that is committed to building a diverse, equitable, inclusive and authentic workplace.

We are an Equal Opportunity and Affirmative Action Employer, and encourage applications from all qualified individuals without regard to race, color, religion, sex, gender identity, gender expression, sexual orientation, national origin, age, marital status, disability or veteran status, or to other non-work related factors.

Burrell is a Smoke and Tobacco Free Workplace.