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