Specialist II, Credit Balance (ROPS)
About The Position
DaVita is currently looking for a Credit Balance Specialist for our Revenue Operations Department. Individuals who excel in this role are highly ambitious, results driven, and willing to "think outside the box." This position requires a high level of attention to detail and the ability to work well as part of a fast paced team. The ideal candidate has a high level of multitasking abilities, strong mathematical and analytical skills, and is driven by resolving open balances with the goal to prevent future rework. In this position, you will analyze EOBs and/or payor correspondence to reconcile system credit balances or potential overpayments, research and resolve problem accounts, and request adjustments. You will effectively identify trends and analyze root causes to drive work efficiently within the team. Hybrid and remote position available. All necessary equipment is provided.
Requirements
- High School Diploma or equivalent required
- 2 years’ experience with accounting, transactions or medical billing systems a plus
- Health care and medical billing/collections/overpayment remediation or experience
- Knowledge or experience working with a variety of health care insurance payers
- Intermediate computer proficiency in Microsoft Office including Excel and Outlook
Responsibilities
- Research, initiate follow-up and resolve all health care insurance claim accounts with existing credit balances (claim(s) paid more than expected by payer); actions included but not limited to initiating refunds, retractions, and/or adjustments to claims
- Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution of claims
- Use critical and analytical problem solving skills to resolve issues
- Uses strong organizational skills to effectively manage large amounts of detailed information
- Utilizes excellent written and oral communication skills to collaborate and maintain positive working relationships with peers, leaders, clinical personnel, and payer representatives to resolve credit balances.
- Contributes to implementation of process improvement initiatives aimed at improving credit department
- Supports monthly reporting of outstanding credit balances
- Stay current on communications relating to healthcare reimbursement and regulatory changes
- Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies
- Understand and adhere to all policies, laws and regulations applicable to this role
- Consistent, regular, punctual attendance as scheduled is an essential responsibility of this position
Benefits
- Medical, dental, vision, 401(k) match, paid time off, PTO cash out
- Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
