Credit Balance Specialist - Healthcare Hospital Claims
About The Position
The Credit Balance Specialist (Hospital Claims) will manage credit balance workloads of patients and respond/follow-up on external and internal inquiries in a timely manner. This person should have a solid understanding of the Revenue Cycle as it relates to the entire life of a patient account from creation to payment. Individuals must be able to work an eight hour shift between the hours of 8:30 AM CT - 5:30 PM CT, with no remote work initially BUT an opportunity for some hybrid (in office/remote) schedules after training. We will consider individuals open to relocation to San Antonio!
Requirements
- High School Diploma / GED.
- 1+ years of working with credit balance accounts (refund, overpayment, underpayment, accounts resolution, etc.)
- Working knowledge of the following: health insurance claims, medical billing, medical coding, credit finance, accounting or customer service-related responsibilities
Nice To Haves
- Credit balance experience within a hospital background
- Experience working within Epic, Meditech or other hospital patient accounting systems.
- Ability to interpret UB-04 claims, payer correspondence, and contractual agreements.
- Basic knowledge of Commercial, Managed Care, Medicare and Medicaid insurance
- PC skills in a Windows environment.
- Knowledge and utilization of desktop applications to include Word and Excel.
- Ability to initiate and follow through on projects and work independently with minimal supervision.
Responsibilities
- Research and resolve patient credit balance accounts resulting from overpayments, duplicate payments, financial assistance adjustments, or insurance reprocessing.
- Analyze overpayments, duplicate payments, coordination of benefits (COB), retro eligibility, and contractual adjustment discrepancies.
- Collaborate with billing, cash posting, denial management, and patient access teams to resolve account discrepancies.
- Process patient refunds accurately and timely in accordance with client policies and regulatory requirements.
- Communicate with patients regarding refund status, account balances, and payment discrepancies professionally and compassionately.
- Maintain accurate, clear, concise and complete account notes and other relevant information.
- Resolve unidentified payments through research.
- Aim to have patient accounts balance to zero prior to accounts being forwarded to an outside agency for collections.
- Assist with internal and external audits related to credit balance processes and refund activity.
Benefits
- Medical, Rx, Dental & Vision Insurance
- Personal and Family Sick Time & Company Paid Holidays
- Parental Leave
- 401(k) Retirement Plan
- Basic Life & Supplemental Life
- Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
- Short-Term & Long-Term Disability
- Tuition Reimbursement, Personal Development & Learning Opportunities
- Skills Development & Certifications
- Employee Referral Program
- Corporate Sponsored Events & Community Outreach
- Emergency Back-Up Childcare Program
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
