Refund Specialist I

US Acute Care Solutions; Ohio; Remote; USD 22,000 - 42,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

401(k) with company contributions

Paid time off and holidays

Bonus eligibility

Job summary

US Acute Care Solutions is hiring a Refund Specialist I to thoroughly research patient accounts and resolve overpayments within the Athena Billing System. You will coordinate with patients, payors, and team members to ensure accuracy and compliance.

The role requires examining unapplied payments, posting corrections, and maintaining clear documentation. It is remote with a competitive benefits package and hourly pay between $16.33 and $30.21.

Qualifications

• Strong knowledge of medical insurance and government payors.
• Experience reviewing Explanation of Benefits and posting.
• Experience with insurance follow-up or payment processing.
• Ability to investigate refunds and reconcile posting discrepancies.
• Proficient in a Windows PC environment and data entry.

Responsibilities

• Investigate refunds and credits for unapplied payments causing overpayments.
• Verify payment application details on accounts for accuracy.
• Trace deposits and detect duplicate postings in batches.
• Initiate refunds via Cedar Portal or Athena when needed.
• Document all corrections and maintain audit-ready notations.

Skills

Payment processing knowledge

Attention to detail

Verbal and written communication

Organizational skills

Overtime availability

Education

High school diploma or equivalent

Tools

Athena Billing System

AthenaOne Billing System

Cedar Patient Portal

Job description

Job Posting Closing Date: Open until Filled

Where do you belong?

Your career is more than just a job, it's part of your life. Whether you're a clinician, or non-clinical professional, at USACS you'll feel a sense of connection working with clinicians and office staff who share your interests and values. We want you to love coming to work each day because you believe in what you do and the people with whom you work. We care about your success.

USACS also understands that location is important. We offer career opportunities for clinicians and non-clinical support staff from New York to Hawaii and numerous points in between. Our supportive culture, outstanding benefits and competitive compensation package is best in class.

Job Description

The Refund Specialist I is responsible for thoroughly researching patient accounts to identify and resolve overpayments, ensuring accurate refund processing or correction of posting discrepancies within the Athena Billing System. This role requires detailed investigation of unapplied payments, coordination with internal systems, and effective communication with patients, payors, and team members to maintain financial accuracy and compliance.

Location: Remote

ESSENTIAL JOB FUNCTIONS:

• Investigate all requested refunds and credit balances by reviewing patient accounts for unapplied payments causing overpayments.
• Verify payment application details on patient accounts to confirm accuracy.
• Analyze internal deposit and payment batches to trace deposit origins and detect duplicate postings.
• Utilize Cedar Patient Portal to confirm relevant payment information and initiate refunds when applicable.
• Correct posting discrepancies in the Athena Billing System promptly and accurately.
• Enter cases and document all necessary corrections within the Athena system.
• Perform adjustments within guarantor accounts and process refunds as required.
• Ensure claims are adjudicated correctly by understanding payer-side claim processes in Athena.
• Maintain comprehensive notations in the system to facilitate clear communication and tracking of account activities.
• Initiate refunds through Cedar Patient Portal or directly via Athena Billing System when portal processing is unavailable.
• Execute complete refund check processes including reissue, void, and returned checks following established protocols.
• Maintain organized backup documentation for all adjusted and refunded accounts to support audit readiness.
• Communicate professionally and courteously with coworkers, management, third-party payors, and patients.
• Assist with additional departmental duties as assigned to support overall team objectives.

KNOWLEDGE, SKILLS AND ABILITIES:

• In-depth knowledge of payment processing functions, medical insurance, government payors, and related terminology.
• Proficiency in using personal computers within a Windows environment, including spreadsheet applications and data entry tools.
• Strong attention to detail with excellent problem-solving skills to identify and resolve discrepancies efficiently.
• Effective verbal and written communication skills, maintaining professionalism and confidentiality at all times.
• Ability to organize workload effectively, manage multiple tasks simultaneously, and adapt to changing priorities.
• Willingness and ability to work overtime as needed to meet business demands.

EDUCATION AND EXPERIENCE:

• High school diploma or equivalent required.
• Minimum of two years combined experience in medical insurance, payment processing, or insurance follow-up preferred.
• Experience with Insurance Websites/Portals/Overpayment Forms required.
• Strong knowledge of Coordination of Benefits including Government and Commercial Carriers required.
• Proficient in review of Explanation of Benefits and Posting required.
• Strong knowledge in Payer initiated recoupments required.
• Experience with AthenaOne Billing System is preferred but not mandatory.

PHYSICAL DEMANDS:

• Regularly required to sit for extended periods; occasional walking, standing, bending, stooping, and lifting up to 15 pounds.
• Must have close visual acuity to perform job duties accurately.

Hourly Rate: $16.33-$30.21

Hourly rate may be determined on several factors including but not limited to knowledge, skills, experience, education, geographical location and requirements stated in job description.

USACS offers a comprehensive and competitive benefits package designed to support the health, well-being, and financial security of our employees.

Benefits may vary based on role, location, and employment status, but generally include:

• Medical, dental, and vision insurance options
• Health savings accounts (HSA) and flexible spending accounts (FSA)
• 401(k) employee and employer contributions
• Paid time off, including vacation, sick leave, and company holidays
• Paid parental leave & family support benefits
• Short-term and long-term disability insurance
• Life and accidental death & dismemberment (AD&D) insurance
• Employee assistance programs & wellness resources

Additional compensation may include bonus eligibility, equity, or other incentive programs, depending on the role.

Specific benefit offerings and eligibility will be provided during the hiring process and may be subject to change in accordance with applicable laws and company policies.