Refund Specialist
Everything we do is underscored by a why and that why is one another.
Location: Altru Health System PO Box 6002 Grand Forks, ND 58201 Pay Range: $17.07 - $25.60
Summary:
The Refund Specialist supports clinic and hospital Business Office staff by processing refunds and distributing insurance payments or adjustments. The Specialist manages accounts through the entire revenue cycle, ensuring accurate payments and securing required medical documentation. The specialist tracks overpayment claims, resolves credit balances, and manages payment work queues.
Essential Job Functions:
- Reviews and processes insurance overpayments and credit balances, initiating refunds and clearing account work queues.
- Assists Business Office staff in refunding or distributing insurance payments and reversing adjustments when appropriate.
- Approves insurance refund requests from the refund/credit work queue.
- Determines refund method (paper check or electronic) based on insurance requirements, retrieves Explanation of Benefits (EOBs), scans refund requests, and mails paper checks with EOBs.
- Assesses late charges and credits, cancels claims from the liability bucket, and adds Insurance Control Numbers from previous EOBs.
- Stays current on state and federal billing requirements and updates relevant departments to ensure compliance.
- Communicates with payers and staff to resolve refund-related issues and ensure timely claim payment processing.
- Performs other duties as assigned or needed to meet the needs of the department/organization.
Education:
Preferred: Associates - Business
Work Experience:
Required: A minimum of 1 year Related Experience
Language Requirements:
This position requires proficiency in reading, writing, and speaking English to ensure effective communication in the workplace and with patients, families, and team members.
Physical Demands :
Sit: Frequently (34-66%) Stand: Occasionally (5-33%) Walk: Occasionally (5-33%) Stoop/Bend: Occasionally (5-33%) Reach: Frequently (34-66%) Crawl: Not Applicable Squat/Crouch/Kneel: Occasionally (5-33%) Twist: Occasionally (5-33%) Handle/Finger/Feel: Continuously (67-100%) See: Continuously (67-100%) Hear: Continuously (67-100%)
Weight Demands: