Credit Balance Assistant

CentraCare•Saint Cloud, MN

18h•Onsite

About The Position

Find your purpose as a Credit Balance Assistant with CentraCare! The Credit Balance Assistant analyzes posted transactions to determine why there is a credit balance and is responsible for accurate completion and resolution of potential credit balances for health plan payers and patients/guarantors. This position requires detailed analysis and critical thinking to determine what is necessary to correct the account. After review, if 1) a refund is appropriate to either patient/guarantor or insurance company, 2) a payment transfer is necessary, or 3) a reversal or correction of a contractual adjustment or an administrative adjustment is warranted, then the Credit Balance Assistant is responsible to correct the postings and/or refund the overpayment to the appropriate party.

Requirements

2 years Minimum of experience in healthcare accounts receivable preferred.
Experience with analyzing Explanation of Benefits (EOB's/Remits) from various insurance companies/payers for hospital and/or clinic billing environment working with third party payers, billing, and terminology preferred.
Demonstrated knowledge of healthcare billing and third party payer requirements.
Excellent communication skills and customer relations principles.
Possesses excellent organization and time management skills.
Experience with use of Microsoft Office applications and related healthcare systems and software.
Ability to prioritize and complete tasks in a timely manner with attention to detail and accuracy.
Must have experience working in EPIC to be successful.

Nice To Haves

Associate Degree Business or a healthcare related program preferred.
Knowledge of health insurance, CPT codes, ICD Codes, Revenue Codes, Claim form locators preferred.

Responsibilities

Responsible for timely submission and resolution of all insurance refunds per regulatory, payer and Corporate Compliance requirements.
Responsible for timely submission and resolution of all self-pay refunds; analyzes other associated accounts, including bad debt, to resolve any outstanding balances.
Researches payments, adjustments, and transfers to ensure the credit/debit balance is completely resolved.
Identifies the originating cause of the refund and compiles a reports for management.
Perform duties accurately and efficiently to maintain accounts receivable at or below organization's goal.
Works in a variety of WQ's verifying accuracy of billing information when determining if the Credit Balance is accurate and doing the necessary next steps for completing the refund and/or appropriate adjustment per department policies and procedures.
Updates insurance coverage as appropriate.
Responds to third party payor outside sources and patient questions and concerns, via mail, by telephone, secure email or in person with confidentiality and promptness.
Maintains and updates constantly changing data received from third-party payers, outside sources and in-house departments to ensure proper handling of customer's accounts.
Interacts with departments on correction of charges, answering questions and relating benefits of third-party payers and state and federal government.
Collaborates with others to research and provide pertinent data to ensure proper reimbursement from the third-party payers and state and federal government.
Researches payments, adjustments, and transfers to ensure that the credit/debit balance is completely resolved.
Collaborates with others to research and provide pertinent data to ensure proper reimbursement from third party payers and state and federal government.
This would include reviewing and compiling information as needed for Credit Balance reports from Medicare and Medicaid.
Identify all updates mandated by outside entities and in-house departments including third party payers and state and federal government to include any technology changes/requirements.
Responsible for integrating system practice management and other available system technologies into the billing process consistent with corporate guidelines.
Collaborates with Finance Department on Unclaimed Property.
Ensures goals, objectives and standards established in conjunction with Leadership are attained.
This will encompass both National and CentraCare measures.
Complies with HIPAA regulations and the organization’s policies/procedures regarding patient privacy and confidentiality.
Attends all relevant seminars and education programs that deal with third party payer changes and updated guidelines.
Successfully complete assigned education within allotted time frame.
Provides cross coverage and backup duties for co-workers.
Accountable and responsible for engaging in committees as assigned.