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Credit Balance Specialist II

2 months ago

Pittsburgh, United States Quick Med Claims Full time
Quick Med Claims (QMC) is a nationally recognized leader in emergency medical transportation billing and reimbursement. QMC is committed to providing services in a manner that ensures compliance with all applicable billing and reimbursement regulations while maximizing the capture of allowable reimbursement for each client. The commitment to adherence to both principles make QMC the partner of choice for emergency medical transportation providers.

QMC is headquartered in Pittsburgh, PA. This is a remote position.

Job Purpose/Summary

The credit balance specialist II is responsible for understanding payor requirements and contracts to determine appropriate next steps. The credit balance specialist II should also be able to accurately review and understand payment postings, adjustments and charges.

Essential Duties & Responsibilities
  • Perform job responsibilities and tasks according to company standards as well as state and federal guidelines
  • Review refund requests on a daily basis to ensure validity of request and process accordingly
  • Identify and share overpayment/adjustment trends with leadership
  • Prepare appropriate refunds forms for payor/provider
  • Upload appropriate documents and information to payor and/or client
  • Review and follow up on refund/offset requests to ensure completion in a timely manner
  • Meet or exceed defined productivity standards
  • Contribute to process improvement processes for credit balances.
  • Ensure compliance with credit balance review processes
  • Manage daily work queues of credit balances for both onshore and offshore teams
  • Works under the Account Receivable management team
Requirements

Minimum Qualifications

Education
  • High School Diploma or equivalent required
  • Associates degree or equivalent preferred
Experience
  • Minimum 2+ years of healthcare claims, billing & collection experience
  • Basic understanding of insurance/claims processing
Licenses, Certifications & Clearances
  • Certified Ambulance Coder (CAC) preferred, not necessary
Knowledge, Skills, Abilities
  • Strong computer skills, including Microsoft Word, Excel and Outlook
  • Excellent verbal and written communication skills
  • Must have good interpersonal, organizational and communication skills
  • Must have good problem-solving skills
  • Ability to work in a fast-paced environment
  • Able have the ability to work with minimal supervision
  • Prior collections or medical billing experience with basic understanding of ICD10, HCPCS and medical terminology is preferred.
Other Responsibilities
  • Performs other related duties as assigned.