Credit Balance Refund Specialist

4 weeks ago


MagstattleBas, Grand Est, United States Catholic Health Initiatives Full time
Overview

We are seeking a highly skilled Credit Balance Refund Specialist to join our team at Catholic Health Initiatives. This role is responsible for facilitating the resolution of insurance and patient credit balances and issuing/requesting refunds, immediate offsets and/or redeterminations as appropriate for patient satisfaction and compliance with applicable regulations.

Responsibilities
  1. Reviews accounts and/or reports, including Explanation of Benefits (EOB)/Electronic Remittance Advice (ERAs), payments, adjustments, insurance contracts and contracting system, insurance benefits, and all account comments; contacts and communicates with insurance companies to gather additional information, as necessary.
  2. Refunds overpayments on accounts and transfers payments to the appropriate accounts.
  3. Verifies all patient account charges are billed to the insurance plan.
  4. Validates that insurance has paid correctly and identifies any patient responsibility.
  5. Conducts appropriate review to accurately transfer payments in accordance with established procedures.
  6. Proactively identifies, researches and resolves (with position scope) unusual, complex or escalated issues, as necessary.
  7. Notifies Supervisor/Manager of ongoing issues and concerns.
  8. Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records.
  9. Adheres to refund approval protocols for non-routine refunds.
  10. Meets quality assurance and productivity standards through identification, reconciliation of credit balance accounts and review of credit balance reports for potential overpayments in accordance with organizational policies and procedures.
Qualifications

Highly Preferred Candidate who has three years of experience of revenue cycle in Healthcare. Graduation from a post-high school program in medical billing or other business-related field is preferred. High School Diploma or GED preferred.

Pay Range

$17.89 - $24.60 /hour



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