Hospital Insurance Refund Specialist - SC, Beaufort - Job

TITLE Hospital Insurance Refund Specialist

ABOUT THE ORGANIZATION

Beaufort Memorial, a not-for-profit hospital founded in 1944 on the banks of the Atlantic Intracoastal Waterway, is licensed for 201 beds (169 acute, 14 rehabilitation and 18 mental health). We are an acute-care hospital, a regional referral center and the largest medical facility between Savannah, Ga., and Charleston, S.C. Fully accredited by The Joint Commission, Beaufort Memorial boasts a dedicated, high-quality medical staff of nearly 230 board-certified or board-eligible providers. Our mission is to enhance the quality of life in the Lowcountry through improved health, innovative partnerships and superior care.

POSITION

Hospital Insurance Refund Specialist

LOCATION

Beaufort Memorial Hospital

FULL-TIME/PART-TIME

Full-Time SHIFT Days

EXEMPT/NON-EXEMPT

Non-Exempt

DESCRIPTION JOB SUMMARY

The Hospital Insurance Refund Specialist is responsible for reviewing, validating, and processing insurance overpayments and refund requests in accordance with payer guidelines, regulatory requirements, and internal policies. This role ensures accurate financial transactions, prevents inappropriate refunds, and supports the integrity of the hospital's revenue cycle.

ONGOING COMPETENCIES

(JOB

SPECIFIC DUTIES & RESPONSIBILITIES

): Refund Processing Review insurance overpayments, credit balances, and refund requests for accuracy and validity. Process approved refunds to insurance carriers, government payers, and third party entities. Ensure refunds are completed within required timeframes to avoid penalties or compliance issues. Verify that all refund transactions are properly documented and posted in the billing system Credit Balance Management Analyze patient accounts to identify true credit balances versus misapplied payments or posting errors. Research root causes of credit balances and coordinate corrections with cash posting, billing, and follow up teams. Prevent inappropriate refunds by validating account activity and payer remittance details. Compliance & Audit Support Ensure all refund activities comply with federal and state regulations, including Medicare/Medicaid rules. Maintain accurate records for internal and external audits. Assist with responding to payer inquiries, audit requests, and compliance reviews. Collaboration & Communication Work closely with insurance companies, internal departments, and finance teams to resolve discrepancies. Communicate clearly with payers regarding refund status, documentation, and required forms. Escalate complex issues to leadership when necessary. Reporting & Documentation Prepare daily, weekly, or monthly reports on refund volumes, aging, and trends. Track refund activity and credit balance resolution metrics. Maintain detailed notes and documentation in the hospital billing system.

POSITION REQUIREMENTS JOB QUALIFICATIONS

EDUCATION:

High school diploma or equivalent required

EXPERIENCE

1-3 years of experience in hospital billing, insurance follow up, cash posting, or credit balance resolution. Experience with hospital billing systems (Epic, Cerner, Meditech, etc.) preferred.

JOB KNOWLEDGE, SKILLS & ABILITIES REQUIRED

Strong understanding of insurance billing, remittance processing, and credit balance workflows. Excellent analytical and problem solving skills. High attention to detail and accuracy. Ability to interpret EOBs, ERAs, and payer guidelines. Strong communication and organizational skills. Ability to work independently and manage multiple priorities.

CERTIFICATIONS/ LICENSES

N/A EOE

STATEMENT

Beaufort Memorial Hospital is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.