Refund Specialist

This is a fully remote position, open to applicants in Ohio.

📋 Description

• Conduct research on patient accounts to identify and rectify overpayments.

• Verify the accuracy of payment application details.

• Analyze internal deposit and payment batches to trace the origins of deposits and identify duplicate postings.

• Utilize the Cedar Patient Portal to validate payment information and initiate refunds.

• Correct posting discrepancies within the Athena Billing System.

• Enter cases and document corrections in the Athena system.

• Perform adjustments on guarantor accounts and process refunds.

• Ensure accurate adjudication of claims by understanding payer-side claim processes in Athena.

• Maintain thorough system notations for communication and activity tracking.

• Initiate refunds through the Cedar Patient Portal or Athena Billing System.

• Manage refund check processes, including reissues, voids, and handling returned checks.

• Keep backup documentation for adjusted and refunded accounts to ensure audit readiness.

• Communicate effectively with coworkers, management, third-party payers, and patients.

• Assist with additional departmental responsibilities as assigned.

⛳️ Requirements

• A high school diploma or equivalent is required.

• A minimum of two years of combined experience in medical insurance, payment processing, or insurance follow-up is preferred.

• Experience with insurance websites, portals, and overpayment forms is mandatory.

• Strong understanding of Coordination of Benefits, including both Government and Commercial Carriers, is required.

• Proficiency in reviewing Explanation of Benefits and posting is required.

• Solid knowledge of payer-initiated recoupments is essential.

• Familiarity with the AthenaOne Billing System is preferred but not essential.

• Comprehensive knowledge of payment processing functions, medical insurance, government payers, and related terminology.

• Proficient in using personal computers in a Windows environment, including spreadsheet applications and data entry tools.

• Strong attention to detail along with excellent problem-solving abilities.

• Effective verbal and written communication skills, maintaining professionalism and confidentiality.

• Ability to organize workload, manage multiple tasks, and adapt to shifting priorities.

• Willingness and capability to work overtime as required.

• Ability to sit for extended periods; occasional walking, standing, bending, stooping, and lifting up to 15 pounds.

• Must possess close visual acuity to perform job duties accurately.

🏝️ Benefits

• Options for medical, dental, and vision insurance.

• Health savings accounts (HSA) and flexible spending accounts (FSA).

• 401(k) contributions from both employees and employers.

• Paid time off, which includes vacation, sick leave, and company holidays.

• Paid parental leave and family support benefits.

• Short-term and long-term disability insurance.

• Life and accidental death & dismemberment (AD&D) insurance.

• Employee assistance programs and wellness resources.

• Eligibility for bonuses, equity, or other incentive programs depending on the role.