Credit Resolution Specialist

Proliance Surgeons•Seattle, WA

2d•$21 - $36

About The Position

The Revenue Cycle Credit Resolution Specialist researches and resolves patient and insurance credit balances, processes refunds and transfers, and responds to refund-related inquiries from patients, payers, and internal teams. The role requires strong account research skills, attention to detail, and the ability to determine appropriate resolutions based on account activity, payer requirements, and established Revenue Cycle processes. This is a full-time Monday–Friday position with flexible start and end times. The work environment and physical demands described are representative of those required to perform the job's essential functions; reasonable accommodations may be made for differently abled persons.

Requirements

High school diploma or equivalent.
Ability to research account activity, identify the cause of a credit balance, and determine the appropriate resolution.
Understanding of healthcare billing, payer reimbursement, patient responsibility, adjustments, refunds, and credit balances.
Strong Excel and Microsoft Office skills.
Strong written and verbal communication, organization, and customer service skills.
Ability to manage multiple assignments, meet established deadlines, document work accurately, and escalate concerns appropriately.
Strong attention to detail and ability to work independently while following established policies and procedures.

Nice To Haves

Additional education.
Previous healthcare revenue cycle, billing, accounts receivable, payment posting, credit balance, refund, or related financial experience.
Experience working with patient and insurance account activity and healthcare reimbursement.
Experience with revenue cycle systems such as NextGen, AMKAI, SIS, Waystar, Phreesia, SharePoint, or similar systems.

Responsibilities

Research patient and insurance credit balances by reviewing payments, adjustments, claim activity, refunds, account notes, and transaction history.
Process patient and insurance refunds using the appropriate payment method and Revenue Cycle system, ensuring accuracy and preventing duplicate refunds.
Review and complete credit transfers, reallocations, overpayment requests, and other assigned credit-resolution work.
Identify insurance credits requiring refunds, claim correction, accounts receivable review, untimely credit adjustments, monitoring, or additional research.
Review assigned reports, work queues, and SharePoint request folders daily and complete requests within established turnaround times.
Maintain clear account documentation, status updates, and supporting information for completed and pending work.
Escalate unclear accounts, system issues, or workflow concerns in a timely manner.
Provide professional and accurate customer service to patients, insurance companies, and internal stakeholders regarding refund and credit-balance inquiries.