Refund Specialist

Job description

Refund Specialist Job Summary: Under the direction of the Revenue Cycle Director, the RCM Refund Specialist is responsible for reviewing, processing, and reconciling patient and payer refunds. This role ensures accuracy, compliance with payer regulations, and timely resolution of credit balances within the billing system. (This is a full time position that will support our RCM team at SouthPark Monday to Friday, 8 am to 5 pm) Requirements: A. Education and Certifications - Reviews patient accounts to identify credit balances and determines appropriate refund action. - Processes refunds to patients and third-party payers in accordance with organizational policies and regulatory requirements. - Performs detailed account analysis to ensure accuracy of balances prior to refund issuance. - Investigates and resolves refund discrepancies, including overpayments, duplicate payments, and incorrect postings. - Ensures compliance with federal and state regulations, payer guidelines, and internal policies related to refunds. - Maintains accurate documentation of all refund transactions and supporting records. - Communicates with payers, patients, and internal departments regarding refund statu...