Savista · 3 days ago

Credit Balance AR

United States

Full-time

Remote

Mid Level

$16/hr - $20/hr

3+ years exp

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Responsibilities

Responsible for credit balances, undistributed payments and requests for refunds

Conducts timely and accurate review of undistributed payments, overpayments, credits and requests for refunds in the patient accounting system

Responsible for taking all steps necessary to facilitate prompt and accurate resolution of payments including follow up with third party payers to determine coordination of benefits, insurance primacy rules and filing order.

Effectively communicate information about insurance billing and follow-up processes to patients and internal customers

Initiate refunds to patients/guarantors, insurance companies, and other third parties by following established refund procedures, contractual obligations, payer and regulatory requirements.

Conduct timely and accurate review of refund requests for payers with contracted recoupment language to reduce future recoupment reconciliations.

Analyze data, identify issues, reach conclusions, and propose strategies for resolution of complex reimbursement issues.

Determine the most effective repayment method based on payor processes, i.e. Manual Refund via Check, Resubmission of corrected claim, Payor Offset.

Responsible for reviewing, validating, and correcting adjustments on accounts based on insurance reimbursement and coverage, contracted payers, and services provided.

Redistribute and/or transfer payments between multiple accounts of the same patient within the patient accounting system.

Validate and update patient demographic and insurance information to ensure accuracy of future claims.

Reconcile misdirected and clearing accounts by researching and posting payments to the correct accounts.

Adheres to all company policies and procedures including, but not limited to those identified within the Standards of Business Conduct and the Employee Handbook, as may be amended from time to time. Adheres to all applicable laws and regulations and the company's governance/compliance program.

Responsible for reporting violations of the company's policies and procedures, Standards of Business Conduct, governance program, laws and regulations through the company's Help Line or other mechanism that may be available at the time of the violation. Assists with internal control failure remediation efforts.

Becomes knowledgeable of internal control responsibilities through training and instruction. Responsible and accountable for internal control performance within their area of responsibility. Participates in the internal controls self-assessment process.

Ensures concerns with internal control design or performance and process changes that impact internal control execution are communicated to management.

Qualification

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Credit Balance ManagementInsurance CollectionsHealthcare Customer ServiceComputer Billing SystemsMS Office ProficiencyContract Management SystemsData AnalysisState Regulations Knowledge