Refund Specialist
: Job Details :

Full-time, 40 Hours/WeekMonday to Friday, 7a.m.- 4p.m.Hybrid (Onsite 2-3 Days/Week)Summary:The Refund Specialist is responsible for accurately validating self-pay refund requests from guarantor's requests or from personal credit balance reports. Responsible for research, review and processing of insurance refunds.Responsibilities:1. Responsible for accurately validating self-pay refund requests from guarantor's requests or from self-pay credit balance reports and processing of checks 2. Investigates the requests for insurance refunds from insurance carriers; investigates insurance claim adjudication, works credit balance reports by payor and processes checks or initiates retractions3. Develops relationships with the insurance carriers for follow up with the carrier if there is a question to ensure the correct refund is issued. 4. Responsible to work refund/audit special projects as directed.5. Reviews and validates credit balance auditor requests.6. Other duties as required.Other information:Technical Expertise1. Experience with ICP-9/CPT-4 coding and terminology is required.2. Experience in processing physician billing and hospital billing is required.3. Numeric aptitude is required.4. Experience working in high-volume setting is preferred5. Experience working with insurance companies is required.6. Experience in healthcare is required 7. Proficiency in MS Office [Outlook, Excel, Word] or similar software is required. Accounting software is required.Education and Experience1. Education: High School Diploma or equivalent is required. Bachelor's degree is preferred.2. Certification: None.3. Years of relevant experience: 0 to 2 years is preferred.4. Years of experience supervising: None.Full TimeFTE: 1.000000