AddressJob Description
The Credit Balance Representative is responsible for various tasks in the Accounts Receivables Credit Balance reconciliation process including but not limited to; examining, correcting and consistently updating patient health information to ensure accurate insurance payments, refunds, and/or follow-up; applying appropriate contractual allowances; resolving patient and insurance carrier inquiries; using on-line systems provided by multiple payers to verify eligibility and benefits and checking claim/refund status; make telephone calls to the payer to ensure payment on submitted claims, maintain appropriate/ consistent documentation on accounts worked; apply proper account management principals to accounts to ensure accurate follow up; identify over-payment trends by payer and notify management; uses worklist software to record activity on accounts worked and reviews worklist productivity reports; identify and resolve all assigned Credit Balances within the appropriate regulatory timeline; assist in identification, research and preparation of periodic documented reporting of Credit Balances. As needed, forwarded accounts with non-governmental Credit Balances to appropriate work group for refund generation.
Responsibilities
- Responsible for the accounts receivable reconciliation process for patient accounts including but not limited to: examining, correcting and consistently updating patient health information to ensure accurate insurance payments, refunds, or follow-up and applying appropriate contractual allowances.
- Review all Credit Balances with third party payer involvement and redirect non-governmental refunds to the appropriate work group.
- Utilize on-line systems provided by multiple payers to submit a cancel or corrected claim to governmental payers in a timeframe consistent with regulatory requirements.
- Review and prepare the Medicare Quarterly Credit Balance Report in a timeframe consistent with regulatory requirements.
- Maintains appropriate/consistent documentation on accounts worked.
- Assist Management in responding to Credit Balance audits received by third party payers.
- Identifies consistent overpayment/Credit Balance trends by payer and notify management.
Qualifications
- High School Diploma or Equivalent Required.
- 6 months relevant customer service and/or business office experience Required.
- 6 months medical billing and/or insurance collections experience Preferred.
- Must be able to demonstrate the following: Medical Terminology, Written communication skills, Verbal communication skills, Medicare regulations, Coding, Excel, WORD, Specific applications to use PC applications to achieve work goal, Office applications: email, fax module, scan PDF, Fast paced work environment, Meeting deadlines, Organized, Time management, Conforming to standards, Phone customer service, Billing process, Manage large data volume, Audit Techniques, Healthcare financial regulations, Insurance collections process, Patient privacy, Data entry,10 key calculator, and Works well within a team structure.
About Us
Baptist Health Care is a not-for-profit health care system committed to improving the quality of life for people and communities in northwest Florida and south Alabama. The organization includes three hospitals, four medical parks, Andrews Institute for Orthopaedic & Sports Medicine, and an extensive primary and specialty care provider network. With more than 4,000 team members, Baptist Health Care is one of the largest non-governmental employers in northwest Florida.
