Senior Refund Analyst
The Refund Analyst is responsible for reviewing, validating, processing, and reconciling customer or provider refund requests with a high degree of accuracy and compliance. This role ensures that all refund activities adhere to internal policies, regulatory requirements, audit guidelines, and service-level standards. The ideal candidate is detail‑oriented, analytical, and experienced in financial or claim-related workflows.
Responsibilities:
- Process system credits on refund/returned checks for TPA claim
- Create refund request letters to advise providers of overpayments to initiate group credits
- Work together with team members on complex issues to ensure outstanding receivables are satisfied
- Create manual check requests to reimburse providers when overpayments were previously satisfied
- Collaborate with Accounting and Disbursements to ensure proper GL Coding is used when issuing payments
- Respond to our recovery vendors timely to approve fees for overpayment recoveries
- The ability to multitask on email requests along with projects as assigned
• Minimum of 5 years’ experience in claims processing
• Proven leadership skills
• Knowledge of Healthrules and CFMS
• Excellent problem-solving skills
• Excellent organizational skills and detail oriented
• Excellent written and verbal communication skills
• Familiarity with ICD-10 codes, CPT-4 codes, and HCPCS codes
• The ideal candidate will have a college degree or similar experience
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Inclusion and Belonging
At AmeriHealth Administrators, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
About Our Company
AmeriHealth Administrators is one of the largest national third-party administrators providing innovative, value-based health benefits programs and outsourcing services for self-funded health plans and other organizations.
The company also provides customized outsourcing services for TPAs and other payers, student health plans, and fully insured products.
AmeriHealth Administrators serves 1 million plan members in all 50 states and processes over 6 million claims annually.
Equal Employment Opportunity
AmeriHealth Administrators is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an AmeriHealth Administrators employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of AmeriHealth Administrators and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by AmeriHealth Administrators or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.