Insurance Credit & Refund Specialist (Hybrid)

Privia Health; Arlington (VA); Hybrid; USD 34,000 - 36,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

Pet insurance

401K

Paid time off

Wellness programs

Expense reimbursement

Job summary

Privia Health is seeking an Insurance Credit Resolution Specialist to process insurance credits in a hybrid Arlington, VA role. You will review overpayments, reconcile credits, analyze EOBs, and prepare refunds while ensuring HIPAA compliance and accurate documentation.

The role requires 3+ years in physician revenue cycle, posting charges, claims follow-up, and experience with refund processing. Salesforce will be used to manage requests from Care Centers.

Qualifications

• 3+ years experience in physician revenue cycle / claims management
• Must comply with HIPAA rules and regulations

Responsibilities

• Identify and review patient accounts with insurance overpayments, ensuring accuracy and compliance with payer guidelines
• Reconcile account balances by applying, transferring, or refunding credits where necessary
• Analyze explanation of benefits (EOBs) and insurance payments to verify credits and resolve discrepancies
• Process refunds for insurance companies in a timely and accurate manner
• Prepare and submit refund requests according to established policies and procedures, to include payer specific workflows
• Ensure proper documentation and communication regarding refund transactions with all relevant parties
• Resolve any outstanding credits or account discrepancies by working with insurance companies, patients, and internal teams
• Maintain detailed records of all credit and refund activities for auditing and reporting purposes
• Respond to inquiries regarding refunds, and resolve issues in a timely and customer‑focused manner
• Be able to work independently tomeet productivity expectations
• Use Salesforce to manage worklists and requests/inquiries from Care Centers

Skills

Revenue cycle knowledge

Independent work

Customer service oriented

Education

High School Diploma

Medical Office Training Certificate

Tools

AthenaOne EMR

Job description

Privia Health is seeking an Insurance Credit Resolution Specialist to process insurance credits in a hybrid Arlington, VA role. You will review overpayments, reconcile credits, analyze EOBs, and prepare refunds while ensuring HIPAA compliance and accurate documentation.

The role requires 3+ years in physician revenue cycle, posting charges, claims follow-up, and experience with refund processing. Salesforce will be used to manage requests from Care Centers.