1

Insurance Refund Specialist Jobs in Delaware (NOW HIRING)

The Insurance Follow-Up and Collections Specialist is responsible for following up on all hospital ... Pursues underpaid claims and submits overpayments for refunds. Documents inappropriate denial and ...

Collection Specialist

Dover, DE · On-site

$35K - $40K/yr

... • Process customer refunds and review account adjustments, including resolving client ... Dental insurance * Disability insurance * Health insurance * Life insurance * Paid time off

A/R Billing

Newark, DE · On-site

$19 - $25.50/hr

We are looking for an AR Billing Specialist to join our team. We are an established practice that ... Identify the root cause of insurance denials, send appeals to payors, and take appropriate actions ...

A/R Billing

Newark, DE · On-site

$19 - $25.50/hr

We are looking for an AR Billing Specialist to join our team. We are an established practice that ... Identify the root cause of insurance denials, send appeals to payors, and take appropriate actions ...

Medical Coder

New Castle, DE · On-site

$18.25 - $24.25/hr

Assists Billing Specialists, Coders, and Patient Accounts Specialists in the ongoing operations of ... Process refunds to insurance companies and patients in accordance with practice protocol.

Insurance Refund Specialist information

What does an insurance refund specialist do?

An Insurance Refund Specialist is responsible for processing and managing refunds related to overpayments or adjustments on insurance claims. They review account information, verify overpayments, and ensure that refunds are accurately issued to patients or insurance companies. Their role involves communication with insurance providers, patients, and internal billing departments to resolve discrepancies and maintain accurate financial records. Attention to detail, knowledge of insurance policies, and strong organizational skills are essential for this position.

What are the key skills and qualifications needed to thrive as an insurance refund specialist, and why are they important?

To thrive as an Insurance Refund Specialist, you need a solid understanding of medical billing, insurance claim processing, and healthcare reimbursement policies, typically supported by experience in medical office administration or a related field. Familiarity with practice management software, electronic health record (EHR) systems, and insurance portals is essential, and a Certified Professional Biller (CPB) or similar certification can be advantageous. Attention to detail, strong organizational skills, and effective communication are important soft skills for accurately resolving refunds and coordinating with patients and insurance providers. These skills and qualifications are crucial for ensuring accurate financial transactions, minimizing errors, and maintaining compliance within healthcare revenue cycle operations.

What are some of the most common challenges faced by insurance refund specialists, and how can they be addressed?

Insurance Refund Specialists often encounter challenges such as navigating complex billing systems, resolving discrepancies between insurance payments and billed amounts, and communicating with both insurance companies and patients to clarify refund details. Staying organized and detail-oriented is essential for managing multiple accounts and ensuring timely processing of refunds. Building strong relationships with colleagues in billing, finance, and customer service departments can help streamline workflows and resolve issues efficiently.

What is the difference between Insurance Refund Specialist vs Insurance Claims Processor?

AspectInsurance Refund SpecialistInsurance Claims Processor
CredentialsHigh school diploma, certifications in insurance or customer serviceHigh school diploma, insurance certifications often preferred
Work EnvironmentOffice setting, customer service interactions, claims reviewOffice environment, data entry, claims assessment
Employer & IndustryInsurance companies, third-party administratorsInsurance companies, healthcare providers
Primary FocusProcessing refunds and resolving billing issuesEvaluating and processing insurance claims

The main difference is that Insurance Refund Specialists focus on handling refunds and billing disputes, while Insurance Claims Processors evaluate and process insurance claims. Both roles require similar certifications and work in insurance settings, but their core responsibilities differ, with Refund Specialists concentrating on refunds and Claims Processors on claim evaluation.

What are popular job titles related to Insurance Refund Specialist jobs in Delaware?

For Insurance Refund Specialist jobs in Delaware, the most frequently searched job titles are:

What job categories do people searching Insurance Refund Specialist jobs in Delaware look for?

The top searched job categories for Insurance Refund Specialist jobs in Delaware are:

What cities in Delaware are hiring for Insurance Refund Specialist jobs?

Cities in Delaware with the most Insurance Refund Specialist job openings:

Infographic showing various Insurance Refund Specialist job openings in Delaware as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 21% Part Time, and 5% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution.

Insurance Credits and Refunds Specialist

Dover, DE • On-site


Bayhealth

7.3

Company rating: 7.3 out of 10

Based on 55 frontline employees who took The Breakroom Quiz

304th of 895 rated healthcare providers

People enjoy working here

Good employer

Recommended by parents


Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 7 days ago


Job description

If you care about the opportunity to grow, to make a difference, to build a future and a life, then we just might have the career for you. Care to talk?
Bayhealth Medical Center is Central and Southern Delaware's healthcare leader with hospitals in Dover and Milford, as well as stand-alone Emergency Department in Smyrna and a hybrid Emergency Department and Urgent Care in Milton. We offer various practice settings throughout Kent and Sussex Counties. Bayhealth Medical Center Kent Campus is 90 minutes from Philadelphia, Washington, DC and Baltimore. Our Sussex Campus is 30 minutes to the Delaware beaches and relaxation in the sand!
Bayhealth Medical Center offers a competitive salary and comprehensive benefits package (for eligible positions) including:
  • Generous Paid Time Off and Paid Holidays
  • Matching 401(k)/403(b) Plans
  • Excellent Health, Dental, and Vision
  • Disability and Life Insurance options
  • On Site Child Care
  • Educational Reimbursement
  • Health Care and Dependent Care Flex Spending Accounts
  • Plus, an array of Voluntary Benefits to include Critical Care Coverage and more!

Location: 30 Old Rudnick Ln
Status: Full Time 80 Hours
Shift: Days
SALARY RANGE: 18.73 - 28.09 HOURLY
General Summary:
Responsible for reconciling patient accounts that remain in credit balance status due to overpayment, contract adjustment posting errors, and other issues. Follows proper control procedures for issuing refunds. Investigates and reports trends of issues which result in credit balances. Must be able to correctly interpret insurance contracts making adjustment or refund determinations with little to no assistance.
Responsibilities:
1. Responsible for researching accounts in a credit balance status and taking the necessary steps to resolve the credit balance. Review remittance advice and other correspondence to correct account balance and/or identify refunds due. Calls payers as appropriate to obtain additional insight into claim processing and payment amount(s). Document outcome of research and actions taken to resolve the credit balance.
2. Correctly interprets Federal and State regulations for Medicare and Medicaid and contract terms for Managed Care, Commercial, and Workers Compensation as applicable to ensure all income is appropriately recorded.
3. Follows proper control procedures and departmental policy for posting necessary contractual, small balance and/or refund adjustments. Timely and accurate submission of adjustments and refund requests for approval based on departmental approval guidelines.
4. Identifies trends and coordinates with SBO Cash Application staff to reduce the volume of credit balance accounts generated from posting activities in the future.
5. Prioritizes work to ensure department and corporate goals are met.
6. Maintains productivity standards and credit balances less than the value of 1 day of average daily revenue.
7. All other duties as assigned within the scope and range of job responsibilities
Required Education, Credential(s) and Experience:
  • Education: High School Diploma or GED
    ;
  • Credential(s): None Required
    ;
  • Experience:
    Required: Three (3) years' experience in hospital billing/collections and/or Banking related collections experience.
    Preferred: Four (4) years' experience in hospital billing/collections and/or Banking related collections experience.

Preferred Education, Credential(s) and Experience:
  • Education: Associate Degree
  • Credential(s): Certified Revenue Cycle Specialist
  • Experience:

To view a full list of all open position at Bayhealth, please visit:
https://apply.bayhealth.org/join/

What Bayhealth (Delaware) employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom