Credit Balance and Refund Specialist
5 days ago
At Advanced Diabetes Supply, we're dedicated to creating a knowledgeable, reliable, and superior diabetes supply company. Our approach, coupled with a commitment to service and innovation, has propelled us to a national leader in the industry. We strive to maintain a casual, fun environment while working hard to provide a positive work culture and respectful atmosphere. If you enjoy working in a collaborative environment, have a passion for excellence, and a bias for action, we may be the perfect fit for you.
About The PositionSchedule: 8:00 AM - 4:30 PM ET, Monday - Friday (HYBRID)
Location: Doral, FL
Position Summary
The RCM Credit Balance and Refund Specialist plays a critical role in resolving credit balance accounts for third-party payers and patients. This involves reviewing claims, payments, and denials while ensuring compliance with industry standards. The ideal candidate will have a strong understanding of payor requirements, contracts, and claims processing to maintain accuracy and exceed customer expectations.
Key Responsibilities- Timely and accurate resolution of credit balance accounts, refund or takeback requests.
- Knowledge of insurance processes, coordination of benefits, claims processing, state and federal statutes regarding overpayment regulations.
- Reviews and analyzes accounts and/or reports from insurance companies and patients to facilitate the resolution of credit balance accounts.
- Utilizes available resources to review payment discrepancies and identify trends/reasons for future discussion.
- Proactively identifies, researches, and resolves unusual, complex, or escalated issues, as necessary. Escalates ongoing issues or concerns to management.
- Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records.
- 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.
- Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function.
- Works with payers, Payer Contracting, RCM leadership, Finance, and any other team members in resolving credit balance issues.
- Completes due diligence on all refund requests to ensure that request is valid and accurate in terms of payer contractual and proper documentation.
- Processes adjustments for accounts with credit balances that have occurred due to posting corrections, write-offs, rate changes.
- Prepares refund packages with all supporting documentation and obtain required signatures for approval.
- Serves as a dedicated resource person to answer questions pertaining to credit balance.
- Recommends and identifies overpayment trends for future billing and collection improvement.
- Adapts quickly to frequent process changes and improvements.
- Is reliable, engaged, and provides feedback as to improve processes and policies.
- Attends all department, team, and company meetings as required.
- Meets company quality standards.
- Embraces and exemplifies ADS core values:
- We put our people first.
- We serve our members with passion.
- We take ownership.
- We pursue excellence.
- We never stop growing.
- High School diploma or equivalent.
- 3-5 years experience in medical revenue cycle with previous posting and remittance experience.
- Knowledge of general concepts and practices that relate to the healthcare field, and specific policies, standards, procedures, and practices that pertain to the assigned function.
- Knowledge of the insurance follow-up process for government and non-government payers, including the CMS 60-day overpayment rule.
- Knowledge of insurance company contract rates.
- General computer skills, typing skills, and a working knowledge of Medicare, Commercial Payer, and HIPAA Compliance.
- Basic understanding of accounts receivables in a healthcare setting.
- Basic math and business calculations.
- Working knowledge of computer/data entry with the ability to learn new systems.
- Basic level of MS Office proficiency.
- Friendly, professional, and effective communications skills; able to calmly present solutions in challenging situations.
- Proactive identification of challenges, and solution-oriented approach to problem solving.
- Service-orientation and aptitude to resolve insurance and/or patient matters.
- Effective analytical skills: able to use inductive and deductive reasoning to anticipate outcomes.
- Self-directed accountability and reliability.
- Effective communication, and interpersonal skills, with the ability to influence and collaborate effectively with cross-functional teams.
- Able to manage and prioritize multiple tasks/projects, work autonomously, and meet deadlines.
- Able to work well in a team environment that promotes inclusiveness and communication among team members.
- Communication using both verbal and written English proficiency.
- Cultural competence.
The physical demands described below are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable employees with disabilities to perform the essential functions. While performing the responsibilities of the job, the employee is required to remain in a stationary position most of the time (stand or sit). While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is frequently required to stand, walk, and reach with hands and arms. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.
Other Requirements- Candidates must successfully pass a background check.
- Candidates must be able to provide proof of eligibility to work in the United States without sponsorship.
Pay ranges may vary depending on location. Actual compensation depends on education, experience, and relevant skills.
Benefits for full-time employees include:
- Health, Dental & Vision options.
- FSA and HSA plan with Employer Contribution.
- Employer paid EAP.
- 401k with 4% Company Match.
- Discretionary Profit-Sharing Plan.
- Paid Time Off (PTO) Including 7 Paid Holidays and a Birthday Holiday.
- On-Site Gym.
- In-house Training Programs.
- A fun culture in a fast-growing organization.
Advanced Diabetes Supply provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type based on race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
-
Credit Balance and Refund Specialist
4 weeks ago
Doral, Florida, United States Advanced Diabetes Supply Full timeAbout Our CompanyAdvanced Diabetes Supply is a leading provider of diabetes supplies, committed to delivering exceptional service and innovative solutions to our customers. Our team is dedicated to creating a positive work environment that fosters growth, collaboration, and excellence.About The PositionWe are seeking a highly skilled Credit Balance and...
-
Credit Balance and Refund Specialist
1 week ago
Doral, Florida, United States Advanced Diabetes Supply Full timeAbout the PositionHours: 8:00 AM to 4:30 PM ET, Monday to Friday (HYBRID)Location: Doral, FLThe Credit Balance and Refund Specialist plays a critical role in resolving credit balance accounts for third-party payers and patients. This position requires a strong understanding of payor requirements, contracts, and claims processing to maintain accuracy and...
-
Credit Balance and Refund Specialist
3 weeks ago
Doral, Florida, United States Advanced Diabetes Supply Full timeAbout the PositionHours: 8:00 AM to 4:30 PM ET, Monday to Friday (HYBRID)Location: Doral, FLJob Summary: We are seeking a highly skilled Credit Balance and Refund Specialist to join our team at Advanced Diabetes Supply. As a key member of our Revenue Cycle team, you will be responsible for resolving credit balance accounts for third-party payers and patients...
-
Credit Balance and Refund Specialist
3 weeks ago
Doral, Florida, United States Advanced Diabetes Supply Full timeAbout the PositionHours: 8:00 AM to 4:30 PM ET, Monday to Friday (HYBRID)Location: Doral, FLJob Summary: We are seeking a highly skilled Credit Balance and Refund Specialist to join our team at Advanced Diabetes Supply. As a key member of our Revenue Cycle team, you will be responsible for resolving credit balance accounts for third-party payers and patients...
-
Credit Balance and Refund Specialist
3 weeks ago
Doral, Florida, United States Advanced Diabetes Supply Full timeAbout the PositionHours: 8:00 AM to 4:30 PM ET, Monday to Friday (HYBRID)Location: Doral, FLJob Summary: We are seeking a highly skilled Credit Balance and Refund Specialist to join our team at Advanced Diabetes Supply. As a key member of our Revenue Cycle team, you will be responsible for resolving credit balance accounts for third-party payers and...
-
Credit Balance and Refund Specialist
5 days ago
Doral, Florida, United States Advanced Diabetes Supply Full timeAbout Our CompanyAdvanced Diabetes Supply is a leading provider of diabetes supply solutions, committed to delivering exceptional service and innovative products to our customers.About The PositionWe are seeking a highly skilled Credit Balance and Refund Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for...
-
Credit Balance and Refund Specialist
2 weeks ago
Doral, Florida, United States Advanced Diabetes Supply Full timeAbout Our CompanyAt Advanced Diabetes Supply, we're dedicated to creating a knowledgeable, reliable, and superior diabetes supply company. Our approach, coupled with a commitment to service and innovation, has propelled us to a national leader in the industry. We strive to maintain a casual, fun environment while working hard to provide a positive work...
-
Credit Balance and Refund Specialist
5 days ago
Doral, Florida, United States Advanced Diabetes Supply Full timeAbout Our CompanyAt Advanced Diabetes Supply, we're dedicated to creating a culture of excellence and innovation. Our team is passionate about delivering exceptional service and support to our members, and we're committed to hiring the best talent in the industry.We're a fast-growing organization that values teamwork, inclusivity, and open communication. Our...
-
Credit Balance and Refund Specialist
5 days ago
Doral, Florida, United States Advanced Diabetes Supply Full timeAbout Our CompanyAt Advanced Diabetes Supply, we're committed to creating a knowledgeable, reliable, and superior diabetes supply company. Our approach, coupled with a commitment to service and innovation, has propelled us to a national leader in the industry. We strive to maintain a casual, fun environment while working hard every day to provide a positive...
-
Credit Balance and Refund Specialist
2 weeks ago
Doral, Florida, United States Advanced Diabetes Supply Full timeAbout the PositionJob Summary: We are seeking a highly skilled Credit Balance and Refund Specialist to join our team at Advanced Diabetes Supply. As a key member of our Revenue Cycle Management (RCM) team, you will be responsible for resolving credit balance accounts for third-party payers and patients.Key Responsibilities:Timely and accurate resolution of...
-
Credit Balance and Refund Specialist
4 days ago
Doral, Florida, United States Advanced Diabetes Supply Full timeAbout Our CompanyAt Advanced Diabetes Supply, we're dedicated to creating a knowledgeable, reliable, and superior diabetes supply company. Our approach, coupled with a commitment to service and innovation, has propelled us to a national leader in the industry. We strive to maintain a casual, fun environment while working hard to provide a positive work...
-
Doral, Florida, United States SNI Financial Full timeAccounts Payables/Accounts Receivables SpecialistWe are seeking a skilled Accounts Payables/Accounts Receivables professional to join our team at SNI Financial. As a key member of our financial operations team, you will be responsible for analyzing vendor invoices, processing payments, and maintaining accurate financial records.Key Responsibilities:Analyze...
-
Credit Card Processing Specialist
1 day ago
Doral, Florida, United States INSPYR Solutions Full timeJob Title: Credit Card Processing ClerkJob Summary:INSPYR Solutions is seeking a skilled Credit Card Processing Clerk to join our team. As a Credit Card Processing Clerk, you will be responsible for processing credit card transactions, ensuring accurate and timely payment processing. Key Responsibilities: Process credit card transactions accurately and...
-
Senior Collections Specialist
4 weeks ago
Doral, Florida, United States Phoenix Pro Connect Full timeJob Title: Collections SpecialistPhoenix Pro Connect is seeking a skilled Collections Specialist to join our team. As a key member of our finance department, you will be responsible for collecting past due invoices, negotiating payment arrangements with customers, and reconciling accounts to ensure accurate balances.Responsibilities:Collect past due invoices...
-
Doral, Florida, United States SNI Financial Full timeAccounts Payables/Accounts Receivables ProfessionalWe are seeking a skilled Accounts Payables/Accounts Receivables professional to join our team at SNI Financial. The ideal candidate will have a solid understanding of basic bookkeeping and accounting principles, as well as experience with financial software such as QuickBooks.Key Responsibilities:Analyze...
-
Accounts Receivable Specialist
4 weeks ago
Doral, Florida, United States MSH Full timeJob Title: Accounts Receivable SpecialistThe ideal candidate will possess strong organizational skills and the ability to accurately track and record cash flow. This position is responsible for setting up and collecting on customer accounts, including creating credit and debit memos, researching payment discrepancies, and providing visibility on cash...
-
Accounts Payable/Receivable Specialist
3 weeks ago
Doral, Florida, United States SNI Financial Full timeAccounts Payable/Receivable Clerk Job DescriptionWe are seeking a highly skilled Accounts Payable/Receivable Clerk to join our team at SNI Financial. As an Accounts Payable/Receivable Clerk, you will be responsible for managing the financial transactions and records of our clients.Key Responsibilities:Analyze vendor invoices for payment accuracy and process...
-
Doral, Florida, United States SNI Companies Full timeJob SummaryWe are seeking a highly skilled Accounts Payables/Accounts Receivables professional to join our team at SNI Companies. As a key member of our finance department, you will be responsible for managing financial transactions, ensuring accurate and timely payments, and providing exceptional customer service.Key ResponsibilitiesAnalyze vendor invoices...
-
Doral, Florida, United States SNI Financial Full timeJob SummaryWe are seeking a highly skilled Accounts Payables/Accounts Receivables professional to join our team at SNI Financial. The ideal candidate will have a proven track record of managing financial transactions, analyzing vendor invoices, and providing exceptional customer service.Key Responsibilities:Analyze vendor invoices for payment and ensure...
-
Doral, Florida, United States SNI Financial Full timeAccounts Payables/Accounts Receivables ProfessionalWe are seeking a highly skilled Accounts Payables/Accounts Receivables professional to join our team at SNI Financial. As a key member of our financial operations team, you will be responsible for managing the entire accounts payable and accounts receivable process, ensuring timely and accurate payment and...
