Refund Specialist III

The Refund Specialist III validates and tracks credits due to insurance companies, patients and other payers. The incumbent of this role is responsible for understanding payor contracts and preparing refund requests. This role may also be assigned to post payments and perform essential cash management duties. Maintains and processes assigned work queue items accurately and within established timelines. Analyzes account activity to determine refund eligibility and ensure correct payment handling. Works with both government and commercial payers to resolve overpayments. Collaborates with internal teams to resolve complex refund-related issues. Identifies trends, potential process improvements, and opportunities to reduce rework. Reviews and resolves charge corrected and non-charge corrected invoices. Submits overpayment requests in payer portals. Prepares Refund Request Forms and supporting documentation regarding refund checks. Maintains HIPAA patient confidentiality standards for medical and financial information. Meets or exceeds department KPI’s and productivity targets. Performs all other duties as assigned.