Refund Coordinator 1

Title: Refund Coordinator

Union: Teamsters 986

Grade: 22

Date: 1/23/2025

Position Summary

The Refund Coordinator 1 is responsible for processing all refunds accurately and in a timely manner.

This involves handling refund requests efficiently, verifying the validity of each request, managing any required documentation, and effectively communicating with customers about the status of their refunds.

"Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role."

Key Duties and Responsibilities


* Maintain the refund database by daily balancing, recording write-off amounts, and processing refund checks.


* Make regular phone calls about overpayments less than 45 days old.


* Refer all uncollectible overpayments to CRS after 45 days.


* Create written communications for providers, members, and other carriers using Microsoft Word software as necessary.


* Assist in resolving any issues that arise with the Finance department as needed.


* Prepare a refund request for the fund.


* Complete daily database balancing 100%.


* Ability to identify potential problems and trends in processes and escalate them for management review.


* Ability to identify potential problems and possible solutions for process improvement.


* Collaboration with colleagues and departments is essential to provide timely and high-quality service.


* Engage with the Customer Relations Service (CRS) daily to discuss refund close-outs and address any complex issues.


* Collaborates with colleagues and departments to ensure timely and high-quality service.


* Provides assistance to participants, co-workers, and vendors in a friendly, courteous, and professional manner.


* Excels in a team environment with minimal supervision


* Ensure adherence to departmental quality and productivity standards as specified in the work standards grid.


* Performs other duties as assigned.

Minimum Qualifications


* High School Diploma or GED.


* A minimum of two years of experience as a Claims Examiner.


* Must have proficiency in using a computer.


* Ensure typing skills meet or exceed the requirements for 35 WPM.



*Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee of this job.

Duties, responsibilities and activities may change at any time with or without notice.

Working Conditions/Physical Effort


* Prolonged periods of sitting at a desk and working on a computer.


* Normal degree of physical effort in typical office environment with comfortable, constant temperatures and absence of objectionable elements.


* May be subject to interruptions.


* Must be able to have flexible work schedule when workflow requires.


* Meets established attendance and punctuality guidelines.


* Must be able to lift 15-...