UPMC logo

Refund Specialist

UPMC

Pittsburgh, PAJobSeen 1 day agoSeen in employer's feed 1 day ago

Evaluate my fit

Most applications go out cold — see where you stand first. No sign-up to start.

Watch jobs like this.

Don't just apply. Show up ready.

Olive works from this exact posting.

At a glance

Compensation
No compensation found
Location
Pittsburgh, PA
Work Authorization
Not specified

Olive lists jobs from US employers, including remote roles you can work from the United States.

Requirements

Credentials this posting asks for.

Act 34

Job overview

The Refund Specialist processes credit balances for insurance and self‑pay refunds, reviews and validates government payer refunds, ensures documentation compliance, prioritizes workflow by balance and aging, and resolves credit account issues while adhering to UPMC core values and applicable regulations.

Skills & qualifications

RequiredNice to have

Skills

Microsoft OfficeMedical TerminologyThird Party Payer GuidelinesReimbursement PracticesProblem SolvingCommunication

Qualifications

High School Diploma or Equivalent and 1 Year Claims Processing Experience or 3 Years Business Office ExperienceBachelor's DegreeAct 34

Full job description

Purpose:

Process all credit balances (insurance and self-pay) for refunds.

Responsibilities:

  • Review credit balances for possible distribution to other debit balances.

  • Ensure that all validated Government payer refunds are processed in a timely manner or within the payer guidelines.

  • Maintain department productivity guidelines.

  • Ensure that proper documentation is attached to all refund requests.

  • Performs duties and job responsibilities in a manner which promotes the core values of UPMC (Quality and Safety, Dignity and Respect, Caring and Listening, Excellence and Innovation, Responsibility and Integrity) in all consumer and UPMC interactions.

  • Maintain compliance with quality standards.

  • Prioritize work flow accordingly by balance and aging criteria.

  • Ensure that all incming refund requests, either via CRM or email, are processed within 3 business days.

  • Identify and take action towards resolution of credit accounts through potential refunds, adjustments, payment transfers, etc. Adhere to the Fair debt Extension Uniformity Act and understand the laws and regulations applicable to job functions.

  • Identify credit balance issues that may impact workflow.

  • Reconcile refund postings.

  • Notify management of any trends identified in workflow creating credit balances.

  • High School diploma or equivalent and 1 year of claims processing, billing or collections experience, OR High School diploma or equivalent and 3 years experience in a business office setting.

  • Bachelor's degree is preferred.

  • Knowledgeable in third party payer guidelines and reimbursement practices required.

  • Effective problem solving skills and ability to make independent decisions required.

  • Good oral and written communication skills.

  • Knowledge of medical terminology, third party payer guidelines and reimbursement practices.

  • Experience or working knowledge of Microsoft Office products (Word, Outlook, Excel) preferred but not required.

  • Strong understanding of all patient accounting systems.Licensure, Certifications, and Clearances:

  • Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran

Similar jobs, posted recently

Open roles like this one, listed in the last 30 days.

You've read the whole posting — now see how you match it.

Evaluate my fit