Refund Analyst
HaloMD specializes in Independent Dispute Resolution (IDR) for out-of-network healthcare providers. The Refund Analyst is responsible for handling and processing customer refunds, overseeing the return of dispute funds, and ensuring financial accuracy and operational efficiency across all IDREs.
Responsibilities
- Organize and maintain reports into a format that can easily be evaluated by Leadership and external parties
- Perform daily reconciliation of outstanding refunds across all 15 IDREs to ensure timely and accurate identification of overpayments
- Analyze payer remittances and IDR settlement data to validate refund eligibility
- Process refund transactions accurately and in compliance with internal controls, payer contracts, and regulatory requirements
- Coordinate with Refund Team Leads and Accounting to resolve discrepancies and ensure proper posting and documentation
- Maintain organized and up-to-date records of all refund activities for audit readiness
- Identify and escalate any discrepancies or issues requiring further investigation
- Assist in month-end reporting and support internal audits related to IDR refund activities
- Collaborate with internal stakeholders to ensure smooth resolution of open refund items
- Strong organizational, analytical, and problem-solving skills
- Knowledge of the Arbitration process
- Proactively assess and implement improvements to the refund handling process
- Professionalism in all dealings, both internal and external customers
- Ability to clearly communicate, both verbally and in writing
- Other duties as assigned
Skills
- 1+ years of refund experience is required
- College degree or equivalent work experience required
- Strong organizational, analytical, and problem-solving skills
- Knowledge of Refunds processing and collections
- Knowledge of independent dispute resolution process
- Ability to clearly communicate both verbally and in writing
- Proficiency in Microsoft Excel and comfort with data analysis and reconciliation tools
- Knowledge of laws that regulates communication and privacy act
- Must maintain professional appearance
- Ability to be at work at regular and consistent times
- Reconciliation experience is highly preferred
- IDR or Healthcare experience is preferred
Company Overview