Credit Balance Specialist

2 weeks ago


Newnan, Georgia, United States Piedmont Urgent Care Defunct Full time
Job Title: Credit Balance Specialist

Piedmont Urgent Care Defunct is seeking a highly skilled Credit Balance Specialist to join our team. As a Credit Balance Specialist, you will play a critical role in analyzing credit balances and ensuring accurate and timely refunds.

Key Responsibilities:
  • Analyze credit balances and determine the most efficient process to resolve refund requests and credit balances
  • Post missing non-EDI payments, contractual allowances, rejection codes, deductibles, and copayments to balance
  • Update and maintain all logs and spreadsheets used for reconciliation
  • Maintain or exceed established productivity goals and quality standards
  • Manage daily credit refund work queues
  • Determine the most efficient process to resolve refund requests and credit balances
  • Maintain current knowledge of insurance policies and processes and work with payers to understand and adopt workflows to manage cash application effectively
  • Utilize all available resources (EOBs, Waystar, Change, payor websites, Availity, etc.) to ensure refunds/take-backs (recoupments) are adjudicated correctly
  • Notify payors of initiated takebacks and submit to management for prior approval
  • Update Epic to ensure proper documentation for refunds and maintain optimal payer mapping
  • Proactively recognize, report, and resolve trends in revenue recognition
  • Identify trends and recommendations to improve revenue cycle processes
  • Conduct research and ad-hoc analysis to support revenue cycle goals
  • Communicate across teams, providing analytical overviews on key metrics
  • Partner with finance, client sites, internal and external billing team to ensure complete billing system and bank reconciliation
  • Assist, as needed, with any other business needs
Requirements:
  • 3+ years working with patient accounts
  • High School Diploma
  • Some college preferred
Preferred Skills:
  • Critical thinking with demonstrated ability to identify root cause of issues and follow-through to resolve
  • Advanced knowledge of insurance payers, and the AR/revenue billing lifecycle
  • Excellent Computer skills - expertise in MS word suite including Word, Excel, and PowerPoint
  • Experience in using one or more Practice Management Systems/Billing Software; EPIC preferred
  • Clear understanding of the impact of payment applications and credit processing has on RCM operations and financial performance
  • Ability to work within a team environment and maintain a positive attitude
  • Excellent documentation, verbal, and written communication skills
  • Extremely organized with a strong attention to detail
  • Self-motivated, dependable, and flexible with the ability to handle periods of stress and pressure


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