Credit & Refund Specialist

Job Description

The Refunds Specialist analyzes data to determine whether or not a refund is warranted, based on contractual agreements and payments received, and administers refunds accordingly. The Credit/Refund Specialist will be responsible for the expedient and accurate refund processing of patient and insurance over payments.

Essential Functions

• Review EOBs and ensure allowances, adjustments, unallocated payments, and overpayments are posted correctly

• Reviews refund requests submitted by the billing team for accuracy, before sending to the accounting department for processing.

• Review and resolve accounts with credit balances/request refunds and/or adjustments as necessary

• Generate reports to identify outstanding credit balances and prepare overpayment packages as necessary

• Initiate and work up refund requests for overpayments

• Process refunds and credit balances to patients or payers

• Identify account problems, patterns, and trends

• Identify patient accounts with credit balances to determine whether or not a refund is due to the patient and/or insurance company.

• Communicate refund status with patients/insurance companies.

• Post adjustment and or payment corrections to patient accounts in billing software.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to ~~~ .

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Skills and Requirements

• 2+ years of experience working with medical refunds.

• High School Diploma or equivalent

• Previous healthcare billing and/or payment posting experience required.

• Understanding of Electronic Response Admittances (ERAs) and Explanation of Benefits (EOBs) - Familiar with Chemotherapy and Radiation Billing null

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion,sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military oruniformed service member status, or any other status or characteristic protected by applicable laws, regulations, andordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to ~~~.