Address
Form of work
SalaryOur Company:
Amerita
Overview: The Credit Balance Specialist I is responsible for facilitating the resolution of insurance and patient CREDIT BALANCEs by payer notification letters, phone communication, refunds, offsets, or revenue adjustments in accordance with applicable state/federal regulations and company policies. The Credit Balance Specialist works closely with other staff to identify, resolve, and share information regarding payer trends and provider updates. The employee must have the ability to prioritize, problem solve, and multitask. Above all, qualified candidates should possess exceptional internal and external customer service skills and actively promote Amerita's company culture.
Responsibilities: - Ensures daily accomplishments by working towards individual and company goals for cash collections, CREDIT BALANCEs, medical records, correspondence, appeals/disputes, accounts receivable over 90 days, and other departmental goals
- Understands and adheres to all applicable state/federal regulations and company policies.
- Understands insurance contracts in terms of medical policies, payments, patient financial responsibility, CREDIT BALANCEs, and refunds
- Reviews CREDIT BALANCE adjustments. Submits payer notification letters and contacts payers in accordance with Amerita’s payer notification process.
- Conducts appropriate review to accurately transfer payments in accordance with established processes
- Initiates and coordinates offsets and cash research requests with the cash applications department
- Utilizes approved credit categorization criteria and note templates to ensure accurate documentation in CPR+
- Creates patient refund packets and validates receipt of previously submitted payer disputes
- Works within established departmental goals and performance/productivity metrics
- Identifies and communicates issues and trends to management
- High School diploma/GED or equivalent required; some college a plus
- A minimum of one to two (1-2) years of experience in revenue cycle management with a working knowledge of Managed Care, Commercial, Government, Medicare, and Medicaid reimbursement
- Working knowledge of automated billing systems; experience with CPR+ and Waystar a plus.
- Working knowledge and application of metric measurements, basic accounting practices, ICD 9/10, CPT, HCPCS coding, and medical terminology
- Solid Microsoft Office skills with the ability to type 40+ WPM
- Strong verbal and written communication skills with the ability to independently obtain and interpret information
- Strong attention to detail and ability to be flexible and adapt to workflow volumes
- Knowledge of federal and state regulations as it pertains to revenue cycle management a plus
- Flexible schedule with the ability to work evenings, weekends, and holidays as needed
