Credit Refund Specialist

Job Summary

Responsible for managing hospital credit balance accounts, the full-time remote Credit Refund Specialist will research, validate, and resolve insurance refund requests and overpayments while ensuring compliance with applicable regulations and standards.

Key responsibilities:

• Analyze and resolve hospital insurance credit balance accounts to ensure accurate refunds are issued when appropriate
• Review insurance refund requests and payer correspondence to determine support for refunds based on claim history and payment activity
• Collaborate with internal teams to support accurate reimbursement and maintain compliant account documentation

Required qualifications:

• Three years of experience in acute care hospital billing, collections, or account resolution
• Knowledge of state and federal regulations related to medical insurance billing and refund handling
• Thorough understanding of UB04 and revenue codes as they pertain to hospital billing
• Experience in processing facility insurance refund requests and resolving account credit balances
• Familiarity with hospital reimbursement contracts and methodologies