<h3>Job Description</h3>
Job Description
Overview
Amerita is a leading provider of Specialty Infusion services focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. As one of the most respected Specialty Infusion providers in America, we service thousands of patients nationwide through our growing network of branches and healthcare professionals. The Refund/Dispute Specialist is responsible for processing incoming payer refund requests by researching to determine whether the refund is appropriate or a payer dispute is warranted in accordance with applicable state/federal regulations and company policies. The Refund/Dispute Specialist works closely with other staff to identify, resolve, and share information regarding payer trends and provider updates. The employee must have the ability to prioritize, problem solve, and multitask. 
This is a Remote opportunity. Applicants can reside anywhere within the Continental USA.
Schedule: Monday-Friday, 7:00AM to 3:30PM Mountain Time
We Offer:
• Medical, Dental &amp; Vision Benefits plus, HSA &amp; FSA Savings Accounts • Supplemental Coverage – Accident, Critical Illness and Hospital Indemnity Insurance • 401(k) Retirement Plan with Employer Match • Company paid Life and AD&amp;D Insurance, Short-Term and Long-Term Disability • Employee Discounts • Tuition Reimbursement • Paid Time Off &amp; Holidays 
 
Responsibilities
<ul>
<li>Reverses or completes necessary adjustments within approved range. Ensures daily accomplishments by working towards individual and company goals for cash collections, credit balances, medical records, correspondence, appeals/disputes, accounts receivable over 90 days, and other departmental goals</li>
<li>Understands and adheres to all applicable state/federal regulations and company policies</li>
<li>Understands insurance contracts in terms of medical policies, payments, patient financial responsibility, credit balances, and refunds</li>
<li>Verifies dispensed medication, supplies, and professional services are billed in accordance to the payer contract. Validates accuracy of reimbursement and the appropriate deductible and cost share amounts billed to the patient per the payer remittance advice.</li>
<li>Reviews remittance advices, payments, adjustments, insurance contracts/fee schedules, insurance eligibility and verification, assignment of benefits, payer medical policies and FDA dosing guidelines to determine if a refund or dispute is needed. Completes payer/patient refunds as needed and validates receipt of previously submitted refunds/disputes.</li>
<li>Creates payer dispute letters utilizing Amerita’s standard dispute templates and gathers all supporting documentation to substantiate the dispute. Submits disputes to payers utilizing the most efficient resources, giving priority to electronic solutions such as payer portals. Scans and attaches disputes to patient’s electronic medical record in CPR+.</li>
<li>Works closely with intake, patients, and payers to settle coordination of benefit issues. Communicates new insurance information to intake for insurance verification and authorization needs. Submits credit rebill requests as needed to the billing department or coordinates patient-initiated billing efforts to insurance companies. </li>
<li>Initiates and coordinates move and cash research requests with the cash applications department. </li>
<li>Utilizes approved credit categorization criteria and note templates to ensure accurate documentation in CPR+</li>
<li>Works within established departmental goals and performance/productivity metrics</li>
<li>Identifies and communicates issues and trends to management</li>
</ul>
 
Qualifications
<ul>
<li>High School diploma/GED or equivalent required; some college a plus</li>
<li>A minimum of one to two (1-2) years of experience in revenue cycle management with a working knowledge of Managed Care, Commercial, Government, Medicare, and Medicaid reimbursement</li>
<li>Working knowledge of automated billing systems; experience with CPR+ and Waystar a plus</li>
<li>Working knowledge and application of metric measurements, basic accounting practices, ICD 9/10, CPT, HCPCS coding, and medical terminology</li>
<li>Solid Microsoft Office skills with the ability to type 40+ WPM</li>
<li>Strong verbal and written communication skills with the ability to independently obtain and interpret information</li>
<li>Strong attention to detail and ability to be flexible and adapt to workflow volumes </li>
<li>Knowledge of federal and state regulations as it pertains to revenue cycle management a plus Flexible schedule with the ability to work evenings, weekends, and holidays as needed</li>
</ul>

Refund Dispute Specialist

<h3>Job Description</h3>
Job Description
About the Role:
Mindpath Health exists to increase access to mental health care that helps people thrive. We do this by empowering our clinicians, investing in our people, and caring for the communities we serve.
The Refund Specialist (Remote in TX, NC, SC, or FL) will accurately identify payor and patient credits, audits Explanation of Benefits (EOBs), insurance denials and Private Practice billing transactions in the NextGen system. The Refund Specialist also communicates with CPA staff members and resolves posting issues as they arise.
Responsibilities
<ul>
<li>Audits encounters and accounts with payer and patient credits in the NextGen system to determine where the credit belongs.&nbsp;</li>
<li>Processes tasks and emails from CPA staff members identifying overpayments.&nbsp;</li>
<li>Manually processes patient credits via PayJunction, InstaMed, and/or paper checks.&nbsp;&nbsp;</li>
<li>Receives takeback EOBs from payer and posts takeback warning in NextGen system.</li>
<li>Processes chargebacks in InstaMed.&nbsp;</li>
<li>Receives emails identifying chargebacks in InstaMed.</li>
<li>Provides proof of signed Credit Card Authorization signed by patients giving CP authority to charge patient’s credit card to Credit Card vendor initiating chargeback.</li>
<li>Manages InstaMed tickets submitted by CPA staff members and assisting with charge/batch issues.</li>
<li>Maintains required reports as defined by Supervisor or Manager of Operations</li>
<li>Actively participates in staff meetings in a positive and constructive manner.</li>
<li>Maintains effective communication and cooperative working relationships with other departments, staff, medical staff, patients, and visitors.</li>
</ul>
Qualifications
<ul>
<li>High school diploma or equivalent</li>
<li>6 months experience with follow-up, auditing, and payment posting</li>
<li>Knowledge of payer websites, processes, local, state, and federal requirements</li>
<li>Proficiency with Microsoft Office (Outlook, Excel, and Word)</li>
<li>Strong math, analytical and reasoning skills</li>
<li>Ability to prioritize, multi-task and work independently</li>
</ul>
The Benefits We offer a robust benefits package to include:
<ul>
<li>Medical, Dental, Vision, and EAP</li>
<li>LTD/Life Insurance</li>
<li>401k with employer match</li>
<li>PTO accrual starting at 15 days per year</li>
<li>Paid Parental Leave</li>
<li>Tuition Reimbursement Program</li>
</ul>
About Mindpath Health
Mindpath Health exists to increase access to mental health care that helps people thrive. We do this by empowering our clinicians, investing in our people, and caring for the communities we serve. As a national leader in mental health services, we are reimagining care delivery, reaching patients and focus on clinical excellence. With a team of more than 500 mental health clinicians, Mindpath Health provides a broad spectrum of psychiatry, interventional psychiatry (including TMS and esketamine) and psychotherapy care.
At Mindpath Health, we offer telehealth and in-person visits and coordinate care with primary care physicians and referring providers to ensure a focus on the total health. Mindpath Health is in-network with most major health insurance providers and has more than 80 locations across California, North Carolina, South Carolina, Florida, Texas, Arizona, and growing.
Join our community and discover how rewarding work can be!
Mindpath Health is an equal opportunity employer. We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, ancestry, age, disability, veteran status, or any other status legally protected by federal, state, or local law.

Refund Specialist

<h3>Job Description</h3>
Job Description
 
Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Claims Refund Specialist, you’ll play an important role in helping us offer customized, self-funded insurance options to our clients and members.
 
Reporting to the Claims Manager and Assistant Claims Manager, the Claims Refund Specialist is responsible for various administrative tasks related to services and claims for our health plans. The ideal candidate is detail-oriented, with exceptional communication skills, and a background in healthcare/insurance processing.
 
Key Responsibilities:
﻿
<ul>
<li>Audit, review, and adjust medical, dental, and flexible spending accounts and Health Reimbursement Account claims.</li>
<li>Review, apply and create refund letters for all lines of business to members and providers.</li>
<li>Reprocess payments when necessary.</li>
<li>Communicate with members, providers, employer group contacts, and other inquirers pertaining to specific refund questions.</li>
<li>Review plan documents for various groups to research and resolve claim processing questions and issues.</li>
<li>Act with urgency to respond to inquiries regarding refund request status-including research and resolution regarding outstanding request.</li>
<li>Perform other related duties, as assigned.</li>
</ul>
 
<ul>
<li>6 months’ experience in healthcare or insurance industry with respect to operations support, including provider maintenance, billing, coding, or customer support.</li>
<li>Experience in health care billing or a background with a health insurance carrier or Third-Party Administrator strongly desired.</li>
<li>Solid time-management skills, with the ability to prioritize multiple tasks, while working with a sense of urgency.</li>
<li>Strong interpersonal skills with excellent verbal and written communication skills.</li>
<li>Basic keyboard and Windows based computer skills required.</li>
<li>Familiarity with Microsoft Excel.</li>
<li>Eager to learn the TPA industry and new concepts and processes.</li>
</ul>
 
Work Environment &amp; Physical Demands:
 
<ul>
<li>Hybrid/ remote work availability may be offered based on meeting key performance metrics.</li>
<li>Prolonged periods of sitting may be required.</li>
<li>Regular use of a computer, keyboard, and mouse is necessary; reasonable accommodations will be provided upon request.</li>
<li>Employees should ensure an ergonomically appropriate desk and chair setup.</li>
<li>Comfort with being on camera for virtual meetings (e.g., Microsoft Teams).</li>
</ul>
 
Benefits:
 
After successfully completing a waiting period, eligible Full-time employees have access to our comprehensive benefits package, including:
 
<ul>
<li>Fantastic medical, dental, and vision insurance*</li>
<li>Twice annual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible!</li>
<li>Company provided Basic Life and AD&amp;D</li>
<li>Company paid Short-Term and Long-Term Disability**</li>
<li>Flexible Spending Accounts*</li>
<li>401(k) Retirement Plan with up to a 6% employer-match** WOW! (100% fully vested after 3 years)</li>
<li>10+ paid holidays</li>
<li>Generous paid vacation and sick time</li>
<li>Annual Volunteer Paid Day</li>
<li>Annual Tuition Reimbursement</li>
<li>Annual Health and Wellness Reimbursement</li>
<li>Lots of fun company events</li>
</ul>
 
Who We are:
 
As a trusted third-party administrator (TPA) specializing in self-funded benefit plans, Cobalt Benefits Group (CBG) is committed to helping employers find high-quality coverage at a cost they can afford. We administer self-funded insurance benefits through our three companies: EBPA, Blue Benefit Administrators of Massachusetts, and CBA Blue.
 
With over 30 years of experience and a dedicated team of more than 200 employees, we work collaboratively to build customized self-funded health plans, manage claim payments and disputes, and administer other specialized programs such as FSAs, HSAs, COBRA, and retiree billing. Join us as we match employers across our region with the right solutions for their employee benefit needs. To learn more about working at CBG, visit <a href="https://www.cobaltbenefitsgroup.com/careers/" target="_blank">https://www.cobaltbenefitsgroup.com/careers/</a>.
 
Benefit Waiting Period Notes:
 
*60 day waiting period
**90 day waiting period
 
Compensation details: 21-22 Hourly Wage
 
PIfa37b15e79b6-25405-37703344

Claims Refund Specialist

<h3>Job Description</h3>
Job Description Description:
 
Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Claims Refund Specialist, you'll play an important role in helping us offer customized, self-funded insurance options to our clients and members.
 
Reporting to the Claims Manager and Assistant Claims Manager, the Claims Refund Specialist is responsible for various administrative tasks related to services and claims for our health plans. The ideal candidate is detail-oriented, with exceptional communication skills, and a background in healthcare/insurance processing. 
Key Responsibilities:
<ul>
<li>Audit, review, and adjust medical, dental, and flexible spending accounts and Health Reimbursement Account claims.</li>
<li>Review, apply and create refund letters for all lines of business to members and providers.</li>
<li>Reprocess payments when necessary.</li>
<li>Communicate with members, providers, employer group contacts, and other inquirers pertaining to specific refund questions. </li>
<li>Review plan documents for various groups to research and resolve claim processing questions and issues. </li>
<li>Act with urgency to respond to inquiries regarding refund request status-including research and resolution regarding outstanding request.</li>
<li>Perform other related duties, as assigned.</li>
</ul>
Requirements:
<ul>
<li>6 months' experience in healthcare or insurance industry with respect to operations support, including provider maintenance, billing, coding, or customer support. </li>
<li>Experience in health care billing or a background with a health insurance carrier or Third-Party Administrator strongly desired. </li>
<li>Solid time-management skills, with the ability to prioritize multiple tasks, while working with a sense of urgency.</li>
<li>Strong interpersonal skills with excellent verbal and written communication skills.</li>
<li>Basic keyboard and Windows based computer skills required.</li>
<li>Familiarity with Microsoft Excel.</li>
<li>Eager to learn the TPA industry and new concepts and processes.</li>
</ul>
Work Environment &amp; Physical Demands:
<ul>
<li>Hybrid/ remote work availability may be offered based on meeting key performance metrics.</li>
<li>Prolonged periods of sitting may be required.</li>
<li>Regular use of a computer, keyboard, and mouse is necessary; reasonable accommodations will be provided upon request.</li>
<li>Employees should ensure an ergonomically appropriate desk and chair setup.</li>
<li>Comfort with being on camera for virtual meetings (e.g., Microsoft Teams) </li>
</ul>
Benefits: 
 
After successfully completing a waiting period, eligible Full-time employees have access to our comprehensive benefits package, including:
<ul>
<li>Fantastic medical, dental, and vision insurance*</li>
<li>Twice annual employer HSA contributions, covering 50% of the HDHP plan's annual deductible! </li>
<li>Company provided Basic Life and AD&amp;D</li>
<li>Company paid Short-Term and Long-Term Disability**</li>
<li>Flexible Spending Accounts*</li>
<li>401(k) Retirement Plan with up to a 6% employer-match** WOW! (100% fully vested after 3 years)</li>
<li>10+ paid holidays</li>
<li>Generous paid vacation and sick time</li>
<li>Annual Volunteer Paid Day</li>
<li>Annual Tuition Reimbursement</li>
<li>Annual Health and Wellness Reimbursement</li>
<li>Lots of fun company events</li>
</ul>
Who We are: 
 
As a trusted third-party administrator (TPA) specializing in self-funded benefit plans, Cobalt Benefits Group (CBG) is committed to helping employers find high-quality coverage at a cost they can afford. We administer self-funded insurance benefits through our three companies: EBPA, Blue Benefit Administrators of Massachusetts, and CBA Blue.
 
With over 30 years of experience and a dedicated team of more than 200 employees, we work collaboratively to build customized self-funded health plans, manage claim payments and disputes, and administer other specialized programs such as FSAs, HSAs, COBRA, and retiree billing. Join us as we match employers across our region with the right solutions for their employee benefit needs. To learn more about working at CBG, visit <a href="https://www.cobaltbenefitsgroup.com/careers/" target="_blank">https://www.cobaltbenefitsgroup.com/careers/</a>.
 
Benefit Waiting Period Notes:
 
*60 day waiting period **90 day waiting period
 Equal Opportunity Employer, including disability/protected veterans 
Compensation details: 21-22 Hourly Wage
 
PI5b8cc2debbc7-25405-37703321

<h3>Job Description</h3>
Job Description
Job Summary: The ideal candidate will have a strong understanding of medical billing, insurance payments, EOBs (Explanation of Benefits), and related financial functions.
Responsibilites: On-site position!
<ul>
<li>
<ul>
<li>Accurately post payments from insurance companies, patients, and third-party payers to patient accounts.</li>
<li>Reconcile deposits and ensure proper allocation of payments.</li>
<li>Review and process adjustments, refunds, and denials as necessary.</li>
<li>Monitor and process insurance recoupments and ensure accurate reversal and reposting of affected transactions.</li>
<li>Investigate and resolve overpayments, including appropriate refunding or adjustment processing.</li>
<li>Manage and process unassigned refunds, researching and applying them correctly or routing to appropriate departments.</li>
<li>Identify and resolve payment discrepancies in a timely manner.</li>
<li>Work closely with internal billing, credentialing, and collections teams to address payment-related issues.</li>
<li>Maintain compliance with HIPAA and company policies.</li>
</ul>
</li>
</ul>
Requirements: 
<ul>
<li>
<ul>
<li>Experience: 3+ years in medical payment posting, revenue cycle, or a related field.</li>
<li>Education: High school diploma or equivalent </li>
<li>Technical Skills: Proficiency in medical billing software</li>
<li>Knowledge: Strong understanding of EOBs, insurance claim payments, adjustments, recoupments, overpayments, and refund processes.</li>
</ul>
</li>
</ul>
For California Applicants:
We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).
This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
Company DescriptionHere at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine. Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us? 
<h3>Company Description</h3>
Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.\r\n\r\nOur commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?

Cash Posting & Refund Specialist

<h3>Job Description</h3>
Job DescriptionCompany Description 
The University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine, University of Maryland School of Nursing and University of Maryland, Baltimore who educate the state's future health care professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban and rural communities across the state of Maryland. UMMS puts academic medicine within reach through primary and specialty care delivered at 11 hospitals, including the flagship University of Maryland Medical Center, the System's anchor institution in downtown Baltimore, as well as through a network of University of Maryland Urgent Care centers and more than 150 other locations in 13 counties. For more information, visit <a href="http://www.umms.org" target="_blank">www.umms.org</a>.
Job Description 
I. General Summary
Under the supervision of the CBO Billing Supervisor ensures that payments are posted, reconciled and reported accurately for all professional fee billing. Determines if applied payments should be refunded; Researches patient’s accounts on all requested refunds and credit balances and completes necessary paperwork to finalize refund process.
II. Principal Responsibilities and Tasks
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
1. Receives and records all non-electronic payments from lockbox or other locations on a daily basis.
2. Reconciles all payment, adjustment and refund batches to the daily journal. Resolves any out of balance batches before closing. Responsible for reporting to CBO Billing Supervisor any problems or issues on the monthly reconciliation. Keeps all batches filed chronologically by date of entry to the system. Monthly inputting post goal of a minimum of $700,000 with less than a 3% error rate.
3. Update patient demographic information into Billing System as required from information received through the lockbox.
4. Posts all manual payments, adjustments and rejections to the correct patient account. Transfers secondary balances to the correct payor or patient as the account dictates. Forwards copies of rejections or incorrect payments to the Accounts Receivable Specialist for research and resolution.
5. Informs the Billing Supervisor of any insurance payment issues (payment below fee schedule, rejection of specific services) and works to resolve the issue, as appropriate.
6. Keeps daily work and batches in an organized manner to facilitate access.
7. Posts all unapplied cash to the appropriate service and patient account. Researches all credit balance accounts to ensure balance is actual credit prior to processing refunds for both insurance and patient amounts, including receiving refund checks, producing letters to patients and sending out checks and letters.
8. Attends all mandated department trainings and staff meetings.
Qualifications 
III. Education and Experience
1. High School Diploma or equivalent (GED) is required.
2. Three years general billing or finance experience preferred.
IV. Knowledge, Skills and Abilities
1. Working knowledge of medical coding and insurance claims processing required.
2. Excellent typing/data entry skills are required.
3. Demonstrated knowledge of MS Office software applications such as Microsoft Excel and Microsoft Word and billing system is required.
4. Ability to maintain a culture of excellent customer service, open and friendly staff relations with all levels of staff.
5. Effective verbal and written communication and listening skills are required to interact with various individuals seeking accounting-related information.
6. Ability to work to deadlines within a stressful environment during month end activities.
 Additional Information 
All your information will be kept confidential according to EEO guidelines.
Compensation
<ul>
<li>Pay Range:$19.5- $27.31</li>
<li>Other Compensation (if applicable):</li>
</ul>
Review the 2024-2025 UMMS Benefits Guide

193 refund-specialist Jobs