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.
Vaccination Update
This job requires that you demonstrate you have been fully vaccinated for COVID-19 prior to the start of employment, to the extent permitted by law.
About Our Company
AmeriHealth Casualty has been successfully returning employees to work since 1994, providing quality medical treatment and care and reducing costs for our customers. With our affiliates, we serve more than 1,800 businesses in the area and have offices in Philadelphia, Camp Hill, and Pittsburgh, PA, and Mount Laurel, NJ.
In 1994, CompServices, Inc. began offering workers’ compensation third-party administration services for manufacturers, municipalities, health care facilities, social services, transportation risk, universities, and retail firms. In 1996, AmeriHealth Casualty Insurance Company was established as an extension of our workers’ compensation claims services — its mission to provide workers’ compensation insurance combined with high quality claims service and cost containment.
AmeriHealth Casualty Insurance Company and CompServices write premiums and administer self-insured programs for over 1,800 customers.
Equal Employment Opportunity
AmeriHealth Casualty is an Equal Opportunity and Affirmative Action 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 Casualty 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 Casualty 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 Casualty or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.