Overview
The Refund Specialist III validates and tracks credits due to insurance companies, patients and other payers. The incumbent of this role is responsible for understanding payor contracts and preparing refund requests. This role may also be assigned to post payments and perform essential cash management duties.
At this time, US Anesthesia Partners does not hire candidates residing in California, Hawaii, or Alaska.
Job Highlights
ESSENTIAL DUTIES AND RESPONSIBILITIES (included but not limited to):
- Maintains and processes assigned work queue items accurately and within established timelines.
- Analyzes account activity to determine refund eligibility and ensure correct payment handling.
- Works with both government and commercial payers to resolve overpayments.
- Collaborates with internal teams to resolve complex refund-related issues.
- Identifies trends, potential process improvements, and opportunities to reduce rework.
- Reviews and resolves charge corrected and non-charge corrected invoices.
- Submits overpayment requests in payer portals.
- Prepares Refund Request Forms and supporting documentation regarding refund checks.
- Maintains HIPAA patient confidentiality standards for medical and financial information.
- Meets or exceeds department KPI’s and productivity targets.
- Performs all other duties as assigned.
Qualifications
Knowledge/Skills/Abilities (KSAs):
- Highschool diploma or equivalent required.
- 5+ years of medical billing experience required.
- Knowledge of medical terminology and computer literacy are required.
- Strong experience with payor contracts.
- 4+ years posting experience.
- Basic office skills required; advanced office skills preferred.
- Strong working knowledge of Excel.
- Strong communication skills both oral and written.
- Accurate data entry skills.
- Attention to detail a must.
- Ability to identify trends in underpayments/overpayments.
*The physical demands described here are representative of those that may need to be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Occasional Standing
- Occasional Walking
- Frequent Sitting
- Frequent hand, finger movement
- Use office equipment (in office or remote)
- Communicate verbally and in writing
US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factors.
