Refund Specialist I

US Acute Care Solutions

Refund Specialist I investigating medical-account overpayments and processing refunds for USACS, a hospital-based emergency and inpatient medicine provider. Correcting Athena billing discrepancies and maintaining audit-ready payment documentation remotely.

Posted 8/5/2026full-timeRemote • Ohio • 🇺🇸 United StatesMid-LevelSenior💰 $16 - $30 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in medical insurance payment processing, including proficiency in the Athena Billing System and strong knowledge of Coordination of Benefits. Capable of effectively communicating with various stakeholders while maintaining attention to detail and problem-solving skills.

Highest-signal resume keywords

Medical Insurance Payment ProcessingAthena Billing SystemCoordination of BenefitsExplanations of Benefits ReviewPayer-Initiated Recoupments

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Payment Processing FunctionsRefund ProcessingData EntryAudit ReadinessPayment Application VerificationDeposit AnalysisCredit Balance InvestigationOverpayment ResolutionGuarantor-Account AdjustmentsDuplicate Posting Detection

Soft Skills

Attention to DetailProblem-Solving SkillsEffective CommunicationOrganizational SkillsAdaptability

Tools & Technologies

AthenaOne Billing SystemCedar Patient PortalWindows EnvironmentSpreadsheet Applications

Industry Keywords

Medical InsurancePayer-Side Claim ProcessesGovernment PayorsCommercial CarriersRefund Check Processes

About the role

Key responsibilities & impact

Thoroughly research patient accounts to identify and resolve overpayments
Process accurate refunds and correct posting discrepancies within the Athena Billing System
Investigate refunds and credit balances by reviewing unapplied payments
Verify payment application details on patient accounts
Analyze internal deposit and payment batches to trace deposit origins and detect duplicate postings
Use Cedar Patient Portal to confirm payment information and initiate refunds
Enter cases and document corrections within the Athena system
Perform guarantor-account adjustments and process refunds
Ensure claims are adjudicated correctly by understanding payer-side claim processes in Athena
Maintain comprehensive system notations for communication and account tracking
Execute refund check processes, including reissue, void, and returned checks
Maintain backup documentation for adjusted and refunded accounts for audit readiness
Communicate with coworkers, management, third-party payors, and patients
Assist with additional departmental duties as assigned

Requirements

What you’ll need

High school diploma or equivalent required
Minimum of two years combined experience in medical insurance, payment processing, or insurance follow-up preferred
Experience with insurance websites, portals, and overpayment forms required
Strong knowledge of Coordination of Benefits, including government and commercial carriers required
Proficient in reviewing Explanations of Benefits and posting required
Strong knowledge of payer-initiated recoupments required
Experience with AthenaOne Billing System preferred but not mandatory
In-depth knowledge of payment processing functions, medical insurance, government payors, and related terminology
Proficiency with personal computers in a Windows environment, including spreadsheet applications and data-entry tools
Strong attention to detail and problem-solving skills
Effective verbal and written communication skills with professionalism and confidentiality
Ability to organize workload, manage multiple tasks, and adapt to changing priorities
Willingness and ability to work overtime as needed
Ability to sit for extended periods and occasionally walk, stand, bend, stoop, and lift up to 15 pounds
Close visual acuity required to perform duties accurately

Benefits

Comp & perks

Medical, dental, and vision insurance options
Health savings accounts (HSA) and flexible spending accounts (FSA)
401(k) employee and employer contributions
Paid time off, including vacation, sick leave, and company holidays
Paid parental leave & family support benefits
Short-term and long-term disability insurance
Life and accidental death & dismemberment (AD&D) insurance
Employee assistance programs & wellness resources
Bonus eligibility, equity, or other incentive programs, depending on the role
Supportive culture
Competitive compensation package
Unlimited paths for advancement