Credit Balance Analyst | Refunds Department | Days | Full-Time

UF Health • Jacksonville, FL

113d

About The Position

The Credit Balance Analyst is responsible for reviewing and analyzing Self-pay and Insurance account credit balances to ensure accurate resolution. This includes distributing/un-distributing, transferring, and/or refunding funds as appropriate for both Physician and Hospital charges. The role requires a thorough understanding of State and Federal Payor Guidelines and involves tracking refund completion by ensuring all stages of the refund process are followed. The analyst will provide explanations for account statuses in response to inquiries received through various channels, including electronic correspondence, fax, email, and phone calls. Timely responses to refund requests from internal and external business partners, such as insurance companies and Revenue Cycle Teams, are essential. The analyst may also need to contact patients and insurance companies to verify payment information and validate mailing addresses. Additionally, the role involves researching accounts with credit balances, analyzing payments based on regulatory guidelines, and ensuring that administrative charges, coding, and billing align with Explanation of Benefits (EOB) details. The analyst will take ownership of assigned workloads to meet departmental metrics and standards while supporting the reduction of accounts receivable balances. Engaging with the Revenue Cycle Department as needed and confirming the accuracy of refund check details are also key responsibilities.

Requirements

• 2 years Medical Billing and/or Insurance Follow-Up - Preferred
• Understanding of basic insurance rules and explanation of benefits is essential - Preferred
• Customer Service skills - Preferred
• Payment posting optional - Preferred
• Knowledge of EPIC - Preferred

Responsibilities

• Understand State and Federal Payor Guidelines.
• Track refund completion by ensuring all stages of the refund process are followed.
• Provide explanations for account status(es) for incoming inquiries via electronic correspondence, fax, email, and phone calls.
• Provide timely responses to refund requests from internal and external business partners, such as insurance companies and Revenue Cycle Teams.
• Contact patients and/or insurance companies to verify 'Pay to' information and validate mailing addresses when applicable.
• Perform all other duties that may be assigned in the best interests of the team and the company.
• Apply knowledge of provider billing and practices to research accounts with credit balances.
• Research and identify the cause of credit balances for various team functions.
• Conduct timely review of outstanding balances, apply overpayments, and/or initiate refunds.
• Analyze payments based on regulatory guidelines, ensuring administrative charges, coding, and billing align with EOB details.
• Take ownership of assigned workloads to meet and/or exceed departmental metrics and standards.
• Engage Revenue Cycle Department as needed to aid in accurate allocation of charges.
• Review, correct, and resolve all account credit balances.
• Confirm accuracy of refund check detail, including demographic information and dollar amount as captured in the Accounts Payable system.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees