Credit Balance Specialist

American Vision Partners•Phoenix, AZ

4d•Onsite

About The Position

This position accurately reviews accounts credit balances to determine appropriate steps to resolve. Reviews payment postings, adjustments and charges to appropriately issue refunds.

Requirements

High School diploma or equivalent
3 years medical billing experience
Active knowledge of CMS guidelines, contracted insurance guidelines and coding policies.
Demonstrated computer literacy
Well-organized with attention to detail
Ability to read and understand oral and written instructions
Excellent math skills
Ability to establish and maintain effective working relationship with team members, clinic staff, payers and patients.
Professional customer service skills.
Have a desire and dedication to work with self-discipline.
Maintains the strictest confidentiality: adheres to all HIPAA guidelines and regulations.

Responsibilities

Accurately reviews outstanding insurance and patient credit balances to determine appropriate party to refund.
Research and review of proper contractual and allowable adjustments.
Prepare refund packets to payers and patients.
Call insurance companies regarding refund requests with the ability to obtain additional information.
Review accounts for proper posting of payments.
Call patients and/or estates to determine proper refund address and verification.
Accurately posting payments, adjustments and refunds as necessary.
Reviews transactions (payments and adjustments) from various sources on a daily basis. Payments sources include Electronic Remittances, paper checks and EOB’s, patients, collection agency, capitation plans, Care Credit and Patient Portal.
Adheres closely to the department’s payment reconciliation process.
Prioritizes work to maximize turn-around time.
Meets or exceeds productivity standards in the completion of daily assignments and accurate production.
Maintain an error rate in accordance with departmental policy.
Makes changes to demographic information as necessary in order to produce a clean patient statement.
Answer and respond to external and internal phone calls in a timely manner.
Check and respond to emails in a timely and professional manner.
Performs all other assigned duties.
Conducts self in accordance with the company’s standard values and policies.
Participates in a variety of educational programs, corporate and professional, to maintain current skill and competency levels.