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Form of workDay (United States of America)
Seeking Breakthrough Makers
Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation.
At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care-and your career.
CHOP's Commitment to Diversity, Equity, and Inclusion
CHOP is committed to building an inclusive culture where employees feel a sense of belonging, connection, and community within their workplace. We are a team dedicated to fostering an environment that allows for all to be their authentic selves. We are focused on attracting, cultivating, and retaining diverse talent who can help us deliver on our mission to be a world leader in the advancement of healthcare for children.
We strongly encourage all candidates of diverse backgrounds and lived experiences to apply.
A Brief Overview
Under direct supervision, responsible for the monitoring and resolution of overpayments resulting in credit balances from insurances and/or patient/family accounts.
What you will do
- Monitors and resolves self-pay or insurance overpayments resulting in credit balance via direct workqueue assignment and/or assigned reports; Submits timely requests for refund submission after performing root cause analysis of credit balance to ensure refund time frames are met, by payor and by the standards implemented by CHOP
- Responsible for review of charges, insurance reimbursement, payor policies, contract discrepancies and apply internal escalation procedures to resolve credit balances, timely.
- Meets production and quality requirements
- Provides excellent customer service to both insurance companies and patients, when necessary
- Completes Mandatory Education requirements, yearly; 6 courses as assigned by Leadership
- Other duties as assigned
- High School Diploma / GED Required
- Associate's Degree Preferred
- At least three (3) years experience in Credit Resolution Required
- At least four (4) years in Healthcare Credit Resolution Preferred
- Excellent attention to detail, organized, and professional. (Required proficiency)
- Ability to solve problems, independently as well as assisted (Required proficiency)
- Good working knowledge of third party insurance and public assistance programs. (Preferred proficiency)
- Certified Patient Financial Services Specialist - Clarivate (Healthcare Business Insights) - within 6 months - Preferred or
- Certified Revenue Cycle Representative (CRCR) - Healthcare Financial Management Association - within 6 months - Preferred
To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must be fully vaccinated against COVID-19 and receive an annual influenza vaccine. Learn more.
Employees may request exemptions for valid religious and medical reasons. Start dates may be delayed until candidates are immunized or exemption requests are reviewed.
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