Credit Refund Specialist

Job Summary

To support accurate reimbursement processes, the full-time remote Credit Refund Specialist will research, validate, and resolve hospital credit balance accounts, insurance refund requests, and related account adjustments while ensuring compliance with applicable regulations.

Key Responsibilities

• Analyze hospital insurance credit balance accounts to ensure timely identification, validation, and issuance of accurate refunds
• Review insurance refund requests and payer correspondence to determine the appropriateness of refunds based on claim history and payment activity
• Collaborate with internal teams to support accurate reimbursement and account reconciliation while maintaining compliance with HIPAA regulations

Required Qualifications

• Three years of acute care hospital billing, collections, or account resolution experience
• Knowledge of state and federal regulations related to medical insurance billing and refund handling
• Demonstrated expertise in reviewing and resolving hospital claim errors and payment discrepancies
• Thorough understanding of UB04 and revenue codes as they pertain to hospital billing
• Extensive knowledge of facility reimbursement contracts and methodologies