Columbia Orthopaedic Group

Job Summary:

The Refund Specialist is responsible for managing and processing patient and insurance refunds efficiently and accurately. This role involves interacting with patients, insurance companies, and internal departments to ensure timely resolution of refund requests. The Refund Specialist plays a crucial role in maintaining financial accuracy and fostering positive relationships with patients and insurers.

Key Responsibilities:

1. Refund Processing:

   - Review and process patient and insurance refund requests in accordance with company policies and procedures.

   - Ensure accurate calculation and verification of refund amounts.

   - Update and maintain refund records in the practice manager.

2. Patient and Insurance Communication:

   - Respond to patient inquiries related to refunds, providing clear and timely information.

   - Communicate with insurance companies to resolve refund issues and obtain necessary approvals.

   - Address and resolve discrepancies or issues related to refund processing.

3. Documentation and Compliance:

   - Maintain thorough documentation of all refund transactions and communications.

   - Ensure compliance with legal, regulatory, and internal policy requirements.

   - Perform periodic audits of refund transactions to ensure accuracy and adherence to policies.

4. Collaboration and Support:

   - Work closely with the billing department to reconcile accounts and resolve billing discrepancies.

   - Collaborate with the finance team to track and report on refund metrics and trends.

   - Assist in developing and improving refund processing procedures to enhance efficiency.

5. Problem-Solving:

   - Investigate and resolve complex refund issues or disputes, escalating to management as needed.

   - Identify process improvements and recommend solutions to enhance the refund process.

Qualifications:

- Education: High School Diploma or equivalent required; Associate’s degree in Finance, Accounting, or a related field preferred.

- Experience: Minimum of [2-3] years of experience in a financial or administrative role, with specific experience in handling refunds preferred.

- Skills:

  - Strong analytical and mathematical skills.

  - Excellent attention to detail and accuracy.

  - Proficient in financial software and Google Suite (Sheets, Docs).

  - Strong communication and interpersonal skills.

  - Ability to handle sensitive information with confidentiality.

Working Conditions:

- Office environment with standard business hours. Potential hybrid after 6 months.

- Occasional overtime may be required to meet deadlines or address urgent issues.

Physical Requirements:

- Ability to sit for extended periods and use a computer.