Refund Specialist Insurance

The Refund Specialist-Insurance is responsible for reviewing accounts, identifying insurance overpayments and credit balances, as well as evaluating and verifying refunds are issued in accordance with current policies and procedures.

Duties & Responsibilities
· Review refund and overpayment requests from insurance payers to determine if overpayment has occurred
· Review and resolve credit balances through credit transfers, account corrections and refund request form completion for manual refund check requests
· Identify root causes and trends contributing to patient and insurance credit balances
· Proactively work with other revenue cycle departments to improve efficiency and reduce and/or eliminate refund issues
· Posts debits for approved refunds
· Research returned checks and collaborates with A/P for reporting to unclaimed property
· Resolves Department credit balance inquiries for transfers and refund check requests
· Ability to work collaboratively and build positive business relationships with clinical areas and the payer community
· Develop and maintain expertise with payer specialty-specific payment policies
· Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure
· Preform special projects as required