Refund Specialist I

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🔥 1 minute ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $16 - $30 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

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US Acute Care Solutions

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2015

🏥 Healthcare

💊 Pharmaceuticals

📡 Telecommunications

💰 Private Equity Round on 2021-02

Healthcare • Pharmaceuticals • Telecommunications

US Acute Care Solutions is a physician-owned company specializing in the management and provision of acute care services across the United States. With a focus on emergency medicine, hospital medicine, and critical care, USACS partners with health systems to enhance patient care and improve the healthcare continuum. Annually, the company serves over 10 million patients and operates more than 500 clinical programs in 30 states, driven by a commitment to innovation, quality, and collaborative healthcare delivery.

📋 Description

• Thoroughly research patient accounts to identify and resolve overpayments • Process accurate refunds and correct posting discrepancies within the Athena Billing System • Investigate refunds and credit balances by reviewing unapplied payments • Verify payment application details on patient accounts • Analyze internal deposit and payment batches to trace deposit origins and detect duplicate postings • Use Cedar Patient Portal to confirm payment information and initiate refunds • Enter cases and document corrections within the Athena system • Perform guarantor-account adjustments and process refunds • Ensure claims are adjudicated correctly by understanding payer-side claim processes in Athena • Maintain comprehensive system notations for communication and account tracking • Execute refund check processes, including reissue, void, and returned checks • Maintain backup documentation for adjusted and refunded accounts for audit readiness • Communicate with coworkers, management, third-party payors, and patients • Assist with additional departmental duties as assigned

🎯 Requirements

• High school diploma or equivalent required • Minimum of two years combined experience in medical insurance, payment processing, or insurance follow-up preferred • Experience with insurance websites, portals, and overpayment forms required • Strong knowledge of Coordination of Benefits, including government and commercial carriers required • Proficient in reviewing Explanations of Benefits and posting required • Strong knowledge of payer-initiated recoupments required • Experience with AthenaOne Billing System preferred but not mandatory • In-depth knowledge of payment processing functions, medical insurance, government payors, and related terminology • Proficiency with personal computers in a Windows environment, including spreadsheet applications and data-entry tools • Strong attention to detail and problem-solving skills • Effective verbal and written communication skills with professionalism and confidentiality • Ability to organize workload, manage multiple tasks, and adapt to changing priorities • Willingness and ability to work overtime as needed • Ability to sit for extended periods and occasionally walk, stand, bend, stoop, and lift up to 15 pounds • Close visual acuity required to perform duties accurately

🏖️ Benefits

• Medical, dental, and vision insurance options • Health savings accounts (HSA) and flexible spending accounts (FSA) • 401(k) employee and employer contributions • Paid time off, including vacation, sick leave, and company holidays • Paid parental leave & family support benefits • Short-term and long-term disability insurance • Life and accidental death & dismemberment (AD&D) insurance • Employee assistance programs & wellness resources • Bonus eligibility, equity, or other incentive programs, depending on the role • Supportive culture • Competitive compensation package • Unlimited paths for advancement