Remote Senior Refund Specialist: Claims Recovery & Analysis

Allied Benefit Systems, LLC; Chicago (IL); Remote; USD 28,000 - 29,000; Full time

Benefits offered by this job

Remote work option

Total Rewards package

Job summary

Allied Benefit Systems, LLC is seeking a Senior Refund Specialist to review and determine solicited refunds based on claim guidelines and plan benefits. The role involves preparing and tracking overpayments from providers and ensuring compliance with client plans.

Responsibilities include evaluating refund requests, investigating discrepancies, coordinating with internal teams, and maintaining accurate overpayment logs, while working in a fully remote setting with a strong emphasis on quality

Qualifications

• High school diploma or equivalent required.
• Minimum 3 years of equivalent work experience.
• Strong analytical skills and knowledge of computer systems.
• Knowledge in CPT and ICD-10 coding terminology.
• Claims recovery experience preferred.
• Proficient in Excel and Word.
• Strong written and verbal communication skills.

Responsibilities

• Review and evaluate refund requests for accuracy, eligibility, and compliance.
• Investigate discrepancies in claims, payments, and billing to determine refund actions.
• Process refunds per company policies and regulatory requirements.
• Contact providers for refund status updates.
• Collaborate with billing, finance, customer service, and provider relations to resolve complex cases.
• Read and ensure refunds follow client Summary Plan Descriptions.
• Prepare and track overpayment letters to providers.

Skills

Excel

Word

CPT/ICD-10 terminology

Claims recovery

Analytical skills

Communication

Education

High school diploma or equivalent

Tools

Excel

Word

Job description

Allied Benefit Systems, LLC is seeking a Senior Refund Specialist to review and determine solicited refunds based on claim guidelines and plan benefits. The role involves preparing and tracking overpayments from providers and ensuring compliance with client plans.

Responsibilities include evaluating refund requests, investigating discrepancies, coordinating with internal teams, and maintaining accurate overpayment logs, while working in a fully remote setting with a strong emphasis on quality