Credit Balance Specialist

Revenue Cycle Dallas, Texas Reference ID: JR3296-POS010003


Description

Summary:

The Credit Balance Specialist promotes a patient-centric environmental approach in appropriately resolving credit balances and requests for refunds.

Responsibilities:

  • Proactively resolve any refund request issues by seeking out and identifying payor trends
  • Working credit balance accounts as required
  • Research accounts and work each refund request letter as a denial
  • Monitor and maintain a high level of productivity and quality of work; Report daily on ETM inventory and prepare appeals relating to coding, provider enrollment, and payment processing issues
  • Keep management abreast of both successes and problems as they occur
  • Research all requests for refunds/payment posting research via ETM in a timely manner
  • Verify refund is necessary prior to initiating a refund
  • Verify accuracy of adjustments posted to the account prior to initiating a refund; including UCR guidelines
  • Verify the accuracy of payments posted to the account prior to initiating a refund
  • Print all backup documentation associated with refund
  • Work all refunds in order specified by the Supervisor
  • Make copies of all pertinent information for the refund to be mailed with the refund check
  • Timely mail all refund checks
  • Accurately and timely log refund batches on daily refund spreadsheet
  • Meet or exceed daily production goals as set by the Management
  • Maintain published quality standards on QA audits
  • Any other duties deemed necessary

Knowledge, Skills, and Abilities:

  • Understand payer EOBs and identify posting errors of payments and adjustments.
  • Must be extremely detail oriented, organized and a self-starter capable of tracking to deadlines and meeting goals.
  • Ability to work autonomously and as a team member, with little supervision required once a goal is assigned.
  • Excellent verbal and written communications skills.
  • May require sitting for long periods of time; also stooping, bending, and reaching for files and supplies.
  • Requires manual dexterity sufficient to operate a computer keyboard, answer a telephone, run a copier and other office equipment as necessary.
  • Vision must be correctable to 20/20.
  • Strong analytical and problem solving skills
  • Strong desktop PC skills in MS Excel
  • Ability to work well in a team environment
  • Professional attitude and demeanor
  • Knowledge of filing appeals
  • Knowledge of demanding claims
  • Understanding of primary/secondary/tertiary payor relations

Educational and/or Professional Qualifications:

  • High school diploma or GED
  • Strong analytical and problem solving skills
  • Strong desktop PC skills in MS Excel
  • Ability to work well in a team environment
  • Professional attitude and demeanor
  • Knowledge of filing appeals
  • Knowledge of demanding claims
  • Understanding of primary/secondary/tertiary payor relations

Previous Experience:

  • Minimum of 3 years Accounts Receivable experience in the healthcare industry
  • Knowledge of the GE Centricity Business product is preferred but not mandatory

Other Special Training/Skills:

  • Understand payer EOBs and identify posting errors of payments and adjustments.
  • Must be extremely detail oriented, organized and a self-starter capable of tracking to deadlines and meeting goals.
  • Ability to work autonomously and as a team member, with little supervision required once a goal is assigned.
  • Excellent verbal and written communications skills.
INDJV