Refund Specialist (Full Time) - Patient Financial Services

Staff Position Description Position Title: Refund Specialist Department: Patient Financial Services Reports to: CBO Cash Applications Manager Position Purpose: All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI’s vision to be among the kindest, highest quality health systems in the country.

Key Responsibilities

Prepares Refund Request Forms and supporting documentation to ensure that refunds are issued accurately and promptly. Performs follow-up on checks that have not cleared the bank and research checks that are returned for insufficient address. Follows state specific unclaimed property laws when submitting uncashed refund checks to the appropriate state annually.

Facilitates voids, reissues, and stop payment requests with facility Accounts Payable Department. Maintains HIPAA patient confidentiality standards for medical and financial information. Review and respond to various patient and insurance refund/offset requests. Reporting & Analysis: Contribute to overall team and departmental objectives by providing insights from refund data; identify trends in refund requests to recommend improvements in products, services, or internal processes to minimize future cancellations and enhance customer experience.

Identifies situations in which contractual adjustments are warranted by determining the original billed amounts as compared to the amounts allowed and prescribed by Medicare / Medicaid and/or managed care contracts, as applicable. Performs other duties as assigned to support overall effectiveness of department and organization Qualifications: Education: High School Diploma or Equivalent Experience: One (1) or more years of experience in medical billing, accounts receivable(AR), or cash reconciliation in a hospital or clinic setting.

One (1) or more years of experience in healthcare billing. Certification/Licensure: N/A Skills and Knowledge: Demonstrates thorough knowledge of medical terminology, medical procedural (CPT) and diagnosis (ICD-9) coding, billing, collections, denials, and payment posting workflow. Basic working knowledge of personal computers and their associate user software is required.

Experience with Microsoft Office products Word and Excel is preferred. Ability to multi-task while working on multiple responsibilities simultaneously. Demonstrated ability to read and analyze an Explanation of Benefits (EOB) or Electronic Remittance Advice (ERA) Familiarity with hospital billing (UB-04) and Physician billing (CMS-1500) Knowledge of commercial, Medicare, Medicaid, and managed care payer processes.

Basic accounting principles for balancing and reconciling payments. Knowledge of general ledger postings and adjustments. Preferences: N/A Work Requirements: Blood Borne Disease Exposure Category: Category III Ability to sit for six to seven hours daily at a computer terminal; occasionally lifts and carries up to 15 pounds of files to storage area; must be able to deal calmly and effectively with frustrated and/or angry clients.

Date Staff Position Description Created / Revised: 02/22/2019; 9/18/2026