Senior Refund Specialist

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

Senior Refund Specialist# Senior Refund SpecialistFully Remote • Allied Benefit Systems - CHICAGO, IL 60606## OverviewSalary Range$20.00 - $21.00 HourlyPosition TypeFull TimeCategoryOperations## Description**POSITION SUMMARY** The Senior Refund Specialist will review, analyze, and make determinations regarding solicited refunds based upon specific claim guidelines and plan benefits. Prepare and track overpayments from providers for solicited refunds. **ESSENTIAL FUNCTIONS*** Review and evaluate refund requests associated with claims for accuracy, eligibility, and compliance* Investigate discrepancies in claims, payments, and billing to determine appropriate refund actions* Process refunds in accordance with company policies, contractual obligations, and regulatory requirements* Contact providers for status updates on refund request* Collaborate with internal teams (e.g., billing, finance, customer service, provider relations) to resolve complex cases* Read, analyze, understand, and ensure refunds are handled in compliance with clients’ Summary Plan Descriptions* Prepare and track overpayment request letters to providers* Review, analyze and add applicable notes to the overpayment log* Assist and support team members as needed and when requested* Other duties as assigned**EDUCATION*** High school diploma or equivalent required**EXPERIENCE AND SKILLS*** Minimum 3 years of equivalent work experience required* Strong analytical skills and knowledge of computer systems* Knowledge in CPT and ICD-10 coding terminology* Claims recovery experience preferred* Proficient in the use of the Excel and Word programs* Strong written and verbal communication skills required**POSITION COMPETENCIES*** Accountability* Communication* Customer Service Orientation* Functional/Technical Skills* Quality Focus* Time and Task Management**PHYSICAL DEMANDS*** This is a standard desk role requiring extended periods of sitting and computer work.**WORK ENVIRONMENT*** RemoteHere at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.