Credit Balance Specialist

Description

ABOUT US
IVX Health is a national provider of infusion and injection therapy for those with Rheumatoid Arthritis, Crohn's Disease, Multiple Sclerosis and other complex chronic conditions. IVX offers a different, better approach to caring for our patients and believes it is vital to take the same approach with our employees. We strive to empower our team to succeed while embodying our core values: Be Kind, Do What's Right, Never Settle, Make It Happen, and Enjoy the Ride.

We are expanding our Revenue Cycle department to add a Credit Balance Specialist! This role is Hybrid meaning there is an expectation to be onsite at the IVX Health Headquarters in Brentwood, TN, 3 days per week and 2 days per week working from home. The schedule for this role is flexible but typically 8:00 AM - 4:30 PM. 

ABOUT THE ROLE

The Credit Balance Specialist at IVX Health plays an important role in providing patient-centric support within the revenue cycle organization. This position is responsible for understanding payer requirements and contracts to determine the appropriate resolution of credit balances and refund requests.  The Credit Balance Specialist is responsible for accurate, thorough, and timely review of payment postings, adjustments, and charges in a fast-paced environment. With strong communication and customer service skills, this role ensures adherence to ethical healthcare practices and safeguarding patient confidentiality in compliance with regulatory requirements.

RESPONSIBILITIES

• Review refund requests daily to ensure the validity of requests and process accordingly.
• Review credit balances to identify and promptly process any eligible refunds for both insurance companies and patients.
• Review and follow up on refund/offset requests to ensure completion in a timely manner.
• Review account transactions and explanation of benefits to determine credits are true overpayments including contract rate comparisons.
• Complete money moves for posting errors identified. 
• Initiate refunds, completing appropriate refund forms for payer.
• Flag booking errors created by system setup errors for system updates.
• Maintain detailed records documenting findings and resolution of errors.
• Ensure compliance with credit balance review procedures reporting overpayments within 60 days of identification.
• Provide recommendations for process improvement changes to reduce credit balances.
• Identify and share overpayment/adjustment trends with leadership.
• Receive and process payer correspondence.
• Receive, sort, scan, and distribute incoming and outgoing mail at the Brentwood office.
• Acts as a team player, supporting colleagues and contributing to a collaborative work environment to achieve departmental objectives.
• Quickly adapt to new tasks and responsibilities, performing duties accurately and independently while prioritizing patient care and satisfaction.
• Maintain knowledge of regulatory requirements including Medicare, Medicaid, OSHA, and HIPAA, ensuring adherence in all interactions and processes.
• Perform all job responsibilities and tasks according to company standards as well as state and federal guidelines.

BENEFITS

• Comprehensive Healthcare: Medical, dental, and vision plans with prescription drug coverage and telemedicine services.
• Flexible Savings: Health Savings Account (HSA) and Health Reimbursement Arrangement (HRA) options.
• Supplemental Coverage: Additional plans for Accident, Critical Illness, and Hospital Indemnity.
• Dependent Care FSA: Pre-tax dollars for eligible dependent care expenses.
• Disability Coverage: Voluntary short-term and long-term disability options.
• Fertility and Family Support: Resources for fertility healthcare and family building.
• Life and AD&D Insurance: Coverage for you and your loved ones.
• Counseling Services: Free counseling for emotional, physical, and financial wellbeing.
• Education Assistance: Tuition reimbursement and certification support.
• CEU Library: Access to Continuing Education Units for career advancement.
• Charitable Giving and Volunteer Program: Matched charitable contributions and volunteer PTO.
• Employee Referral Bonus: Earn bonuses for referring talented individuals.
• 401(k) Plan: Save for retirement with company matching.

Note: Please be aware that the benefits described above may vary for Full Time, Part Time, and PRN employees. Please consult your HR representative for details on eligibility and coverage.

Qualifications

ESSENTIAL COMPETENCIES

• Advanced proficiency in working with insurance and managed care plans, including a deep understanding of benefit structures, coverage terms, and claims processes.
• Ability to navigate and utilize payor portals efficiently.
• Previous experience and knowledge of clinical office procedures, medical practice, and a comprehensive understanding of medical terminology relevant to the healthcare environment.
• The ability to perform calculations with attention to detail to ensure accuracy.
• Demonstrates exceptional written and verbal communication abilities to effectively interact with patients, colleagues, and external stakeholders.
• Capable of identifying, evaluating, and resolving problems efficiently, using analytical skills and sound judgment to address challenges that arise in patient financial interactions.
• Self-disciplined, with the ability to work independently and effectively prioritize workload to meet deadlines.
• Proficient in standard office software applications such as Microsoft Office (Word, Excel, PowerPoint), Outlook for email communication, and collaboration tools like Teams, and able to use effectively in daily operations.
• Commitment to ethical healthcare practices, including compliance with HIPAA guidelines and protecting patient privacy.

REQUIRED EDUCATION & EXPERIENCE

• High school diploma or GED required.
• Associate’s degree in healthcare administration preferred.
• Minimum of three (3) years experience in coding, billing, and revenue cycle functions in a healthcare setting. 
• Experience with credit refunds is highly preferred.
• Experience in Excel and Centricity is highly preferred. 
• Basic understanding of infusion/oncology practice management preferred

PAY RANGE
Pay is based on a number of factors including market location, job-related knowledge, skills, and experience, and is benchmarked against similar organizations to our size and industry. For our Credit Balance Specialist role, we generally pay new hires between $22.00 and $25.00 per hour. It is not typical for an individual to be hired at or near the top of the range for roles and compensation decisions are dependent on the facts and circumstances of each situation. In addition to cash pay, full-time regular positions are eligible for 401(k), health benefits, and other company benefits; some of these benefits may also be available for part-time positions.

EEO STATEMENT
IVX Health is proud to be an Equal Opportunity Employer. We value diversity and are committed to creating an inclusive environment for all employees. IVX Health wants to have the best available people in every job, and we make employment decisions on the basis of business needs, job requirements, individual qualifications, and merit. Equal employment opportunities are provided to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, pregnancy, national origin, military and veteran status, age, physical or mental disability, genetic characteristic, reproductive health decisions, family or parental status, or any other legally protected category in accordance with applicable federal, state, or local laws. IVX Health prohibits discrimination, harassment, or retaliation of any kind based on any of these characteristics. Equal employment opportunity will be extended to all persons in all aspects of the employer-employee relationship and all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation benefits, and separation of employment.

Salary : $22 - $25