• Look through patients’ accounts and review and verify amounts due by using the billing systems.
• Process, research, and resolve the credit balances and refunds and review refund requests to determine appropriate resolutions.
• Follow up on open balances that are listed on the monthly accounts receivable and payer follow-up reports.
• Review and update patient demographics, and payer information according to set protocols and procedures.
• Perform reconciliation to obtain receipt summaries, and urgently resolve balance discrepancies.
• Research and process refund transactions, including duplicate payments and checks that have been received in error.
• Process completed refund applications, and prepare accounts for proper reimbursement of payments.
• Respond to patients’ inquiries in person, in writing, over the phone, and through emails.
• Report incorrect billing issues and patient concerns to the management to ensure that they are resolved quickly.
Refund Specialist Qualifications
Usually, a high school diploma or a GED equivalent is sufficient to work as a refund specialist. Some employers may ask for a bachelor’s degree as well.
If you have some experience in a billing capacity, specifically in the medical arena, you may be considered an excellent choice to hire.
Refund specialists are required to be hands-on in determining payments owed to different parties. They need to possess exceptional communication skills, and the ability to handle a wide variety of tasks associated with calculating amounts, and posting them in the database.
They serve as patient advocates and aim to identify reimbursement coverage options for both insured and non-insured patients. Working as a refund specialist can be tricky at times, as one has to work with numbers quite a lot, but if you have a good head for them, you can be a professional at this work in no time.
People working at this position are required to keep in touch with risk management and accounting teams so that they can handle their work effectively, which is why it is crucial to possess exceptional skills in communicating with people from different backgrounds.