Refund Specialist

JOB SUMMARY: REFUND SPECIALIST

Join a team of dedicated Patient Accounting specialists committed to helping the patients and families of Mt. Washington Pediatric Hospital, where everyone contributes to the mission of maximizing the health and independence of the children we serve.

The Refund Specialist prepares insurance and patient credit balances for resolution, as organized and directed by the Patient Finance Manager/Director. Hybrid remote/on-site options may be available after training period.

ESSENTIAL FUNCTIONS OF POSITION

· Refunds will be appropriately investigated and processed following proper accounting methods and established procedures.

· The Refund Specialist will interact with physicians, administration, clinical, accounting and staff personnel to resolve credit balance issues.

· Procedural Knowledge Responsible for the resolution of credit balances for insurance and patient balances.

· Initiate refunds, offsets, and adjustments.

· Exchanges information with individuals outside the assigned department or institution.

· Ability to analyze, research and answers refund questions.

· Responsible for the reconciliation of refunds to the Expanse billing system.

· Interacts closely with the Patient Accounting staff when refund/balance problems occur.

· Maintain supporting chronological notes that detail action taken to resolve outstanding account balances.

· Follow liability policies and established workflows Assists with payment posting and month-end closing.

POSITION REQUIREMENTS

Educational Requirements

• High School/Diploma/Equivalent preferred

Licensure, Certification and Registration

• None

Work Orientation and Experience

· 3 years prior experience in hospital collections.

Knowledge/Skills/Abilities

· Strong payer knowledge base.

· Extremely accurate with figures and data entry.

· Strong analytical skill a must.

· Demonstrates excellent customer service skills

· Highly effective interpersonal skills

· Must be able to work unsupervised.

· Must be computer proficient – PC, Excel, Outlook, Word.

· Must be efficient and a multi-tasker

· Working knowledge of adding machine, calculator, fax machine, printer and copier

· All other duties as assigned or requested

Other Requirements Specific to Assigned Area

Reporting Relationships

• Supervision Received
• Reports directly to Manager/Director

Interpersonal Relationships

• Communicates daily in person or by telephone with hospital staff and insurance companies. Must also be able to handle sensitive situations in a professional manner

PHYSICAL ENVIRONMENT/WORKING CONDITIONS

Typical health care environment, stress due to multiple demands, shifting priorities and tight timeframes. Little or no risk of exposure to body fluids, infectious waste or blood borne disease.

This job description identifies the general nature and level of work to be performed. It is not to be considered an exhaustive list of responsibilities, duties or skills required of an incumbent.

Revised 11/24/25