Credit Balance Specialist - FT - Day - MSO/Centralized Billing Lawrenceville NJ

Capital Health (US)•Pike, NY

7d•Onsite

About The Position

Performs all hospital and professional billing credit balance resolution tasks for insurance and other third-party payors to full completion as assigned by the Credit Balance Resolution Coordinator. Research credit balances, provides supporting evidence, communicates findings and performs billing system adjustment or other necessary actions to resolve credit balances. Prepares, submits, and ensures completion of refunds and retractions where appropriate to resolve credit balances.

Requirements

High school diploma or equivalent.
One year experience in accounting, finance, or healthcare Revenue Cycle billing operations.
Knowledge of Revenue Cycle billing functions, such as pre-bill edits, claim submission, accounts receivable or payment posting.
Experience working in excel.
Ability to take direction, work independently, and meet assigned deadlines.
Research skills.

Nice To Haves

Experience as an end user in Epic, Athena, or Cerner preferred

Responsibilities

Performs assigned tasks for all government, commercial, and special, contracted and non-contracted insurers, including other third-party payors to resolve credit balances
Takes direction and supports the Credit Balance Resolution Coordinator with communication and collaboration with billing and cash applications staff if needed
Research credit balances and provide supporting evidence, communicates findings and performs billing system adjustments or other necessary actions to resolve credit balances.
Prepares, submits, and ensures completion of refunds and retractions where appropriate to resolve credit balances.
Performs billing tasks to resolve credit balances as assigned.
Reviews host billing systems, cash posting reports, EOBs, claims status documentation, payer portals, and communicates with insurance company customer service representatives for accurate research to determine the cause of credit balances.
Tracks and trends historical and current credit balance data to help identify potential future credit balance risks.
Routinely reviews credit balances to identify payment calculation variances with contracts, fee schedule, and claims where appropriate.
Reviews pre and post applied adjustments to the billing systems in accordance with daily, weekly, and monthly expectations for root cause analysis, corrections, and prevention.
Supports larger credit balance projects with payer documentation preparation and meeting participation (where needed).
Performs other duties as assigned.