Insurance Refund Specialist

Insurance Refund Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL Salary: $26 per hour Who We Are Exact Billing Solutions is a unique team of revenue cycle management professionals specializing in the substance use disorder, mental health, and autism care fields of healthcare services. We have extensive industry knowledge, a deep understanding of the specific challenges of these markets, and a reputation for innovation. With our proprietary billing process, EBS is the oil that brings life to the engines of its partner healthcare companies. EBS is poised for exponential growth, and we are building out our teams to support the expansion of global operations. Part of the ICBD family office portfolio, Exact Billing Solutions combines entrepreneurial speed with the financial discipline of a self-funded, founder-led organization. Our growth reflects a proven ability to solve complex healthcare challenges with operational precision, scalable systems, and client-first innovation. Our Origin Story Exact Billing Solutions was launched to address one of healthcare's most persistent challenges: the burden of billing and insurance administration on providers. With firsthand knowledge of how inefficiencies in revenue cycle management drain resources from patient care, our founder built a company dedicated to removing obstacles, accelerating cash flow, and delivering peace of mind to clients across specialties. Recognition & Awards Exact Billing Solutions contributes heavily to the success of the broader ICBD family office ecosystem and benefits from the recognition awarded to other portfolio companies, including: Inc. 5000, 2024 - Top 5 Fastest-Growing Private Companies in America (ABA Centers of America) EY Entrepreneur Of The Year U.S. Overall Florida Trend Magazine - 500 Most Influential Business Leaders About the Role The Insurance Refund Specialist is responsible for reviewing, processing, appealing, and reconciling insurance overpayments and refunds within a healthcare organization. This role ensures compliance with payer regulations, internal policies, and accounting standards while maintaining accurate financial records. The specialist works closely with billing, collections, and accounting departments to identify and resolve credit balances in patient and insurance accounts. The principal functions of the position identified shall not be considered as a complete description of all the work requirements and expectations that may be inherent in the position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position. Key Responsibilities The following are duties and responsibilities that the Insurance Refund Specialist shall provide: Review insurance and patient accounts for credit balances and determine refund eligibility. Research and analyze overpayments, duplicate payments, and payment posting errors. Process refund requests in accordance with payer guidelines, organizational policies, and regulatory requirements. Prepare and submit refund checks or electronic refund requests to insurance carriers or patients. Communicate with insurance companies to confirm refund requirements and resolve discrepancies. Document all refund and adjustment activities in the practice management or billing system. Maintain compliance with HIPAA, payer contracts, and federal/state regulations related to refunds and overpayments. Participate in audits and provide supporting documentation as needed. Assist in developing and improving refund workflows to enhance efficiency and accuracy Requirements Qualifications The Insurance Refund Specialist requires a minimum of a(n): High school diploma or equivalent required; associate's or bachelor's degree in healthcare administration, accounting, or related field preferred. 2 years of experience in medical billing, insurance, or managed care industry settling patient accounts or a related healthcare area Experience with insurance refund processing, credit balance resolution, and payer correspondence preferred. Strong analytical and problem-solving abilities. Excellent attention to detail and organizational skills. Proficiency in medical billing software and electronic health record (EHR) systems. Knowledge of CPT, ICD-10, and insurance payment posting processes. Ability to interpret Explanation of Benefits (EOBs) and payer remittance advice. Effective written and verbal communication skills. Benefits Outstanding Benefits 21 paid days off (15 PTO days, increasing with tenure, plus 6 holidays) Flexible Spending Account (FSA) and Health Savings Account (HSA) options Medical, dental, vision, long-term disability, and life insurance Generous 401(k) with up to 6% employer match About Exact Billing Solutions Exact Billing Solutions is committed to building a culture of professionalism, accountability, and operational excellence. We believe billing is more than a back-office function-it's a vital part of delivering quality healthcare. By hiring individuals with the right blend of expertise, integrity, and client focus, we empower providers to thrive while making the business of healthcare more efficient and sustainable. Join our mission and help transform healthcare billing with precision and purpose!