Insurance Refund Analyst

4 weeks ago


Atlanta, Georgia, United States Rose International Full time

Position Overview:

We are seeking a dedicated Refund Specialist to join our Credits Team within the Revenue Operations Department. This role is essential for individuals who are ambitious, results-oriented, and possess a strong ability to think creatively.

Work Schedule:

  • Hourly position, Monday to Friday, 8-hour shifts, totaling 40 hours per week (includes a 30-minute unpaid lunch break daily).
  • Overtime is not available unless approved by leadership for special circumstances or projects.

Initial 120 Days:

  • PST: 8 am – 4:30 pm
  • MST: 8:30 am – 5 pm (7:30 am – 4 pm PST)
  • CST: 8:30 am – 5 pm (6:30 am – 3 pm PST)
  • EST: 9 am – 5:30 pm (6 am – 2:30 pm PST)

Key Responsibilities:

  • Conduct thorough analysis of Explanation of Benefits (EOBs) and payer correspondence to reconcile credit balances or identify potential overpayments.
  • Research and resolve problematic accounts, and initiate necessary adjustments.
  • Identify trends and analyze root causes to enhance team efficiency.
  • Utilize critical thinking and problem-solving skills to address outstanding claim balances.
  • Maintain strong organizational skills to manage detailed information effectively.
  • Communicate clearly and maintain positive relationships with peers, leadership, clinical staff, and payer representatives.
  • Contribute to process improvement initiatives within the credit department.
  • Ensure compliance with established internal control procedures and stay updated on healthcare reimbursement and regulatory changes.
  • Maintain confidentiality of all company and patient information in accordance with HIPAA regulations.
  • Adhere to all relevant policies, laws, and regulations applicable to this role.
  • Consistent attendance is essential for this position.

Qualifications:

  • Minimum of 4 years of hands-on refund experience required.
  • High School Diploma or equivalent is necessary.
  • Experience in healthcare and medical claim overpayment remediation is essential.
  • 2-4 years of experience with accounting, transactions, or medical billing/accounting systems is required.
  • Familiarity with various healthcare insurance payers is preferred.
  • Intermediate proficiency in Microsoft Office, including Excel and Outlook, is required.

What We Offer:

  • All necessary workstation equipment will be provided.

Equal Opportunity Employment:

Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other characteristic protected by law.



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