Refunds Specialist

EMS Management & Consultants, Inc.; Clemmons (NC); On-site; USD 21,000 - 29,000; Full time

Benefits offered by this job

Discretionary bonus plan

Health coverage

Retirement plan

Paid time off

Job summary

EMS Management & Consultants, Inc. is seeking a Refund Specialist to identify when refunds are needed and to prepare required paperwork for processing. You will monitor workflows, maintain client-specific processes, and collaborate with internal teams to ensure accurate recoupments and transfers.

The role requires a High School Diploma and intermediate Excel/data-entry skills. A discretionary bonus plan, comprehensive benefits, retirement plan, and PTO are offered as part of total rewards.

Qualifications

• High School Diploma required.
• Intermediate Excel skills to manipulate data.
• Ability to collaborate with multi-departmental teams.
• Strong typing and data entry skills.
• Highly organized and proactive with minimal supervision.
• Willing to adapt to changes in work environment and duties.

Responsibilities

• Identify when a refund is required.
• Prepare documentation to initiate a refund.
• Monitor workflows to meet turnaround times.
• Maintain client-specific refund processes.
• Coordinate with internal teams on recoupments and transfers.
• Review documents and update SOPs for the Refund Department.
• Provide coaching and training to business partners on refunds.
• Act as liaison between client, partner and internal teams.
• Answer calls promptly and professionally.
• Communicate in writing and verbally with clients and partners.
• Support company mission and values.

Skills

Excel

Typing

Data entry

Collaboration

Education

High School Diploma

Job description

Job Summary

This position is responsible for identifying, addressing and quality auditing all aspects of overpayments and needed refunds.

Description

Job Summary

This position is responsible for identifying, addressing and quality auditing all aspects of overpayments and needed refunds.

Major Responsibilities/Activities

• Identify when a refund is required
• Prepare a “packet” containing the essential paperwork to initiate a required refund
• Monitor workflows to ensure the team’s established turnaround time goal is achieved or exceeded
• Maintain client‑specific processes to achieve highest client satisfaction
• Coordinate with internal teams in the processing of recoupments and payment transfers
• Review internal company documents and make suggestions of required updates
• Create new and update existing job aids and sops when needed for the Refund Department
• Quality audit team members refund paperwork to ensure the refund is compliant and the obligatory documents have been included
• Provide feedback, coaching and training to business partners which perform tasks related to refunds
• Act as the liaison between the client, business partner and internal
• Answer phone calls quickly and in a pleasant, professional manner
• Professional written and oral communication to all clients, business partners and internal customers
• Consistently support and demonstrate the company mission and values

Other Responsibilities/Activities

• Deliver refund documents by email or the secured file transfer protocol ensuring PHI and financial documents are delivered to the correct recipient
• Provide administrative support as directed
• Research and respond to inquiries in a timely manner
• Perform other necessary tasks as assigned by manager
• Follow all HIPAA compliance guidelines

Requirements

Required Education, Skills, & Experience

• High School Diploma
• Intermediate Excel skills with the ability to manipulate data
• Ability to collaborate effectively with multi-departmental and diverse teams
• Strong, accurate typing and data entry skills
• Highly organized with ability to be proactive, manage time, and prioritize work with little supervision
• Willing and able to adapt to changes in work environment, procedures, priorities, schedule, and job duties

Preferred Education, Skills, & Experience

• Knowledge of HIPAA requirements and regulations
• Previous medical billing experience
• Understanding of Medicare, Medicaid, commercial, liability and patient reimbursement/billing
• Solid understanding of insurance and liability payment methods and regulations

Working Environment/Physical Requirements

• General office environment
• Typing, sitting, standing, walking, some light lifting
• Use of basic office equipment such as computer, fax, printer, copier, telephone, scanner
• Infrequently required to work extended hours without advanced notice due to business needs

Pay: $18.00/hour. Individuals in this role are eligible to participate in a discretionary bonus plan and a comprehensive benefit package, including a retirement plan, health coverage, and paid time off. Visit https://emsmc.com/careers/ to explore our total rewards package.

Employees must be able to perform the essential functions of this position. Reasonable accommodations will be provided to qualified individuals with disabilities as needed to support their ability to perform these essential functions. If you require an accommodation for this position or to participate in the application process, please contact HR at [e-mail].

The responsibilities and duties outlined in this job description are not exhaustive and may be subject to change to meet the needs of the business. This job description is not an implied contract of employment and does not alter the at-will employment relationship.

There is no anticipated closing date for applications; The role will remain open until filled.

Applicants must be authorized to work in the United States now and in the future; this role does not offer current or future visa sponsorship.