Credit Resolution Analyst, Patient Financial Services

Children’s Hospital of Philadelphia • Philadelphia, PA

3d • $28 - $35 • Hybrid

About The Position

The Credit Resolution Analyst supports Children’s Hospital of Philadelphia’s Professional Billing (PB) teams by maintaining financial accuracy, compliance, and operational excellence. The role works in PB credit-resolution queues to investigate credit balances and account discrepancies, review payment and adjustment activity, identify root causes, and complete appropriate resolutions, including refunds. The position is 80% remote and combines independent production work with collaboration across Patient Financial Services and other departments.

The analyst reviews Epic credit work queues and daily credit-balance reports, reconciles account transactions and expected reimbursements with payer contracts, documents account updates, and applies relevant billing rules and appeal processes. The role also supports internal controls, reporting, data quality, process improvement, and operational efficiency. It requires knowledge of revenue-cycle workflows, third-party reimbursement, billing regulations, payer rules, privacy requirements, and organizational policies. The analyst may train and cross-train colleagues, meet productivity and quality expectations, communicate recommendations to management, and perform other duties within the role’s scope.

Requirements

• High school diploma or GED.
• At least two years of experience in billing, payment posting, operations, or a related role.
• Proficiency in HIPAA compliance standards.
• Effective communication, interpersonal, analytical, and problem-solving skills.
• Customer-service skills, customer focus, and the ability to understand CHOP customer needs.
• High-level knowledge of claim-submission requirements.
• Ability to work cooperatively in a team environment.
• Effective verbal and written communication skills.
• Knowledge of Microsoft Office applications, including Word and Excel; high proficiency in Microsoft Excel.
• Excellent organizational and time-management skills.
• Ability to use 10-key by touch.
• Experience using multiple computer applications.
• Experience with commonly used electronic health records and healthcare revenue-cycle financial management systems.
• Detail- and results-oriented approach and high aptitude for math.
• Ability to work independently and prioritize work.
• Basic computer skills.
• Ability to research complex account issues, make sound decisions, and manage multiple requests and deadlines while maintaining accuracy and compliance.

Nice To Haves

• Bachelor’s degree.
• At least three years of experience in billing, payment posting, operations, or a related role.
• Experience with Epic systems.
• Knowledge of third-party reimbursement and physician or hospital billing.
• Experience using commonly used electronic health records and healthcare revenue-cycle financial management systems.

Responsibilities

• Review individual credit accounts in Epic credit work queues and daily credit-balance reports to determine the root cause of credit balances.
• Analyze credit-related account elements accurately and in a timely manner.
• Identify trends and root causes for credits and collaborate with appropriate parties to minimize refunds.
• Review account transactions, including expected and actual reimbursement and the posting of payments and adjustments, for consistency with payer contracts.
• Resolve credits in a timely manner, taking appropriate action, including issuing refunds.
• Update systems and processes to ensure accounts are appropriately documented.
• Apply knowledge of third-party contract language, appeals processes, medical billing regulations and guidelines, payer-specific rules, and accounts receivable terminology.
• Maintain knowledge of fee schedules, contracts, and claim payment systems to support credit-balance resolution.
• Use analytical, reporting, and data-mining or data-extraction skills to support credit resolution and operational work.
• Suggest performance and quality-improvement solutions and provide feedback to team leaders.
• Understand CHOP revenue-cycle workflows, including registration, billing, payment posting, accounts receivable follow-up, and compliance actions.
• Provide training to new employees and cross-training as assigned.
• Meet established daily and weekly productivity and quality expectations.
• Maintain protected health information in accordance with HIPAA, JACHO, contractual agreements, and CHOP policies and procedures.
• Protect privacy and confidentiality, organizational assets, and ethical conduct; report non-compliance and follow applicable laws and regulations.
• Promptly report safety hazards, accidents, incidents, and unsafe working conditions.
• Demonstrate CHOP’s ICARE values: Integrity, Compassion, Accountability, Respect, and Excellence.
• Communicate and collaborate with Patient Financial Services and other departments on operational efficiency.
• Recommend corrective actions to management to improve revenue-cycle efficiency.
• Perform other duties as assigned within the scope of the responsibilities.

Benefits

• 80% remote work and flexibility while remaining connected to a supportive team.
• A culture that values work–life balance.
• Collaborative culture with knowledgeable professionals.
• Opportunity to strengthen technical skills and deepen understanding of Professional Billing revenue-cycle operations.

What This Job Offers

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