Credit Balance Specialist - FT - Day - Hospital Billing Lawrenceville NJ

Capital Health (US) • Pike, NY

67d • $21 - $27 • Onsite

About The Position

Capital Health is seeking a Credit Balance Specialist to perform all hospital and professional billing credit balance resolution tasks for insurance and other third-party payors. This role involves researching credit balances, providing supporting evidence, communicating findings, and performing necessary billing system adjustments or other actions to resolve them. The specialist will also prepare, submit, and ensure the completion of refunds and retractions as appropriate.

Requirements

• High school diploma or equivalent.
• One year experience in accounting, finance, or healthcare Revenue Cycle billing operations.
• Possesses 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.

Benefits

• Medical Plan
• Prescription drug coverage & In-House Employee Pharmacy
• Dental Plan
• Vision Plan
• Flexible Spending Account (FSA) - Healthcare FSA, Dependent Care FSA
• Retirement Savings and Investment Plan
• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
• Disability Benefits – Long Term Disability (LTD)
• Disability Benefits – Short Term Disability (STD)
• Employee Assistance Program
• Commuter Transit
• Commuter Parking
• Supplemental Life Insurance - Voluntary Life Spouse, Voluntary Life Employee, Voluntary Life Child
• Voluntary Legal Services
• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance
• Voluntary Identity Theft Insurance
• Voluntary Pet Insurance
• Paid Time-Off Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED