Refund Specialist I

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

📋 Description

• Conduct comprehensive research on patient accounts to pinpoint and rectify overpayments.

• Accurately process refunds and amend posting discrepancies within the Athena Billing System.

• Examine refunds and credit balances by assessing unapplied payments.

• Confirm payment application specifics on patient accounts.

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

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

• Log cases and document corrections within the Athena system.

• Carry out guarantor-account adjustments and process refunds accordingly.

• Ensure proper adjudication of claims by comprehending payer-side claim processes in Athena.

• Maintain detailed system notations for effective communication and account tracking.

• Implement refund check processes, including reissuance, voiding, and handling returned checks.

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

• Engage in communication with colleagues, management, third-party payers, and patients.

• Support additional departmental tasks as assigned.

⛳️ Requirements

• High school diploma or equivalent is necessary.

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

• Required experience with insurance websites, portals, and overpayment forms.

• Strong understanding of Coordination of Benefits, including both government and commercial carriers is required.

• Proficient in reviewing Explanations of Benefits and posting is essential.

• Required strong knowledge of payer-initiated recoupments.

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

• Extensive knowledge of payment processing functions, medical insurance, government payors, and relevant terminology.

• Proficiency in personal computers operating within a Windows environment, including spreadsheet applications and data-entry tools.

• Strong attention to detail coupled with excellent problem-solving skills.

• Effective verbal and written communication skills with a focus on professionalism and confidentiality.

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

• Willingness and capability to work overtime when necessary.

• Ability to sit for prolonged periods and occasionally walk, stand, bend, stoop, and lift up to 15 pounds.

• Close visual acuity is required for accurate performance of duties.

🏝️ Benefits

• Options for medical, dental, and vision insurance.

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

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

• Paid time off that 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.

• Access to employee assistance programs and wellness resources.

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

• A supportive workplace culture.

• A competitive compensation package.

• Unlimited opportunities for advancement.