Credit Reconciliation Representative I

American Addiction Centers • Milwaukee, WI

2d • $22 - $33 • Remote

About The Position

This is a full-time, remote position within the Enterprise Revenue Cycle - Credit Processing department. The Credit Reconciliation Representative I is responsible for analyzing and resolving credit balances and refund requests for Advocate Health Hospital and Professional Billing entities. This role ensures that appropriate contract reimbursement rates are applied and utilizes multiple systems to accurately resolve credit balances. The representative will determine the responsible payor for overpayments, verify benefits coordination, reimbursement calculations, and payment sources, adhering to system processes and department procedures. Additionally, the role involves identifying and reporting root causes of credit balances and payer refund trends, documenting all actions taken, and contributing to improvement initiatives. The position also requires assisting Level II staff with ad hoc projects and supporting patient accounting activities during high-volume periods.

Requirements

• High School Graduate
• Typically requires 1 year of experience in a healthcare business related setting
• Good organizational ability and communication skills (written and verbal).
• Ability to read, enter and retrieve information from multiple patient accounting systems.
• Basic understanding of Microsoft Office
• Basic bookkeeping skills and a strong mathematics aptitude.
• Able to work independently, under pressure in a fast-paced environment.
• Strong attention to detail and maintains a high degree of accuracy.
• Managed Care payer contract terms and Medicare/Medicaid payer guidelines.
• Ethical conduct.
• Regular and reliable attendance

Responsibilities

• Analyze and resolve credit balances and refund requests within Advocate Health Hospital and Professional Billing entities, ensuring appropriate contract reimbursement rates are applied.
• Utilize multiple systems to review and resolve credit balances accurately.
• Determine the payor responsible for overpayment, verify benefits coordination, reimbursement calculations, and payment sources, and follow system processes and department procedures.
• Identify and report root causes of credit balances and payer refund trends, collaborating with internal and external counterparts.
• Document all actions taken to resolve credit or refund requests in patient and guarantor account notes.
• Possess knowledge of refund/adjustment processes and utilize systems/applications proficiently to resolve credit balances and process refunds.
• Contribute to improvement initiatives and department/system goals.
• Adhere to Advocate Health Revenue Cycle policies, procedures, guidelines, and productivity standards, maintaining personal growth and development.
• Assist Level II staff with ad hoc projects and related job activities to support department operations, including patient accounting activities during high volume periods or impending deadlines.

Benefits

• Competitive compensation
• Generous retirement offerings
• Programs that invest in your career development
• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

What This Job Offers

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