Insurance Refunds & Claims Specialist (Hybrid)
Core
Process insurance-related credits, refunds, and overpayments for physician practices by reviewing correspondence, reconciling accounts, and resolving discrepancies.
Role type
Insurance credit resolution specialist
Builds
Insurance refund checks and credit adjustments for physician practices
Domain
Healthcare revenue cycle management
Required skills
Insurance claims processing, account reconciliation, Explanation of Benefits (EOB) analysis, HIPAA compliance, Salesforce, medical billing workflows
Preferred skills
AthenaOne EMR experience, physician revenue cycle background
Responsibilities
Review and respond to daily correspondence from physician practices, prepare and mail insurance refund checks, reconcile account balances, analyze EOBs to verify credits, resolve outstanding credits or discrepancies with insurance companies and patients, maintain detailed records for auditing, respond to refund inquiries
Seniority
Mid-level, hands-on IC