Credit Balance Representative

Sanford Health•Sioux Falls, SD

3d•$16 - $26

About The Position

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. We are seeking a team member who is eager to learn and develop new skills along with being proactive in seeking and applying feedback across a variety of real‑world scenarios involving healthcare claims. The ideal candidate is confident in making independent decisions, using sound judgment while staying aligned with established processes and expectations, and discerning when to investigate further or when to escalate. This role is perfect for someone who enjoys research across multiple sources and systems to find answers and solve problems, yet understands how to balance thoroughness with efficiency. Facilitate the resolution of insurance and patient credit balances to ensure patient satisfaction and compliance with federal or state regulations.

Requirements

High school diploma or equivalent preferred.
Previous experience in medical billing preferred.
Accounts receivable experience preferred.
Must meet standard productivity requirements prior to moving to a home-based position; if meeting productivity requirements but with less than one year working in Sanford office, must have Director approval to move to a home-based position.

Responsibilities

Must have strong attention to detail and accuracy partnered with strong problem solving skills.
Document and resolve outstanding unidentified credit balances.
Receive incoming refund requests or correspondence and work to resolve and return credit balances to the appropriate entity.
Identify trends in credit balances and work with supervisor to resolve overpayments.
Review credit balances on accounts to resolve by correction, refund or inquiry.
Work closely with both internal and external customers.
Provide assistance to other departments on demand regarding inquiries on credit balances.
Extensive use of electronic billing systems.
Plan, prioritize, organize and complete work to meet established production goals, quotas and deadlines in a fast pace and ever changing environment.
Must demonstrate critical thinking skills to manage day-to-day basic operations.
Must be able to do work steadily, efficiently and show constant vigilance to the details of the work.
Must have good working knowledge of all insurance and government rules regarding payment, credit procedures, claims submittal and appeal processes.
Comply with all regulatory bodies and agencies.
Must be able to use appropriate reference materials when needed.
Clear understanding of the impact payment applications and refund/credit processing has on revenue cycle operations and financial performance.