Credit Balance Representative

Responsible for analyzing credit balances to determine the cause of credit balances, facilitate account resolution of credit balances and posting of refunds as needed. The position requires professional Customer interaction and adherence to MEDTEAM best practice methodologies.

Responsible for analyzing insurance and patient payments posted to patient accounts to determine causes of credit balances.  

• Understands all aspects of payor contracts in terms of payments and refunds.
• Utilizes appropriate software and reporting to identify credit balances and determine action for refunding.
• Identifies overpayments and requests refunds to the appropriate party assuring compliance with hospital policies and procedures.
• Process/post payments, refunds, and adjustments with the goal of account accuracy and customer satisfaction.
• Works to facilitate account resolution of refunds through attention to detail, problem solving and dedication servicing customers.
• Monitors and reports to leadership of any trends identified and documents cash posting/credit balance/refunding issues.
• Participates and completes special projects assigned by leadership to improve ongoing operations within the department.
• Develop workflows to improve internal process and efficiency.
• Works in partnership with other teams and team members to resolve outstanding items.
• Recommends, maintains and updates department documentation
• Maintains documentation regarding Customer interaction
• Provide training in areas of expertise and support for training documents necessary to assist clients as required
• Maintains in-depth knowledge of software core products
• Attend and participate in team and departmental meetings
• Maintain application & industry knowledge through self-study and by attending training classes
• Responds to email and phone communications timely
• Ensure that all HIPAA Privacy and Security/Compliance requirements and responsibilities are adhered to constantly
• Assists the leadership team with recommended improvements
• All other duties as assigned

Knowledge, Skills and Abilities:

• Basic knowledge of hospital revenue cycle terminology.
• Proven ability to understand and interpret reason for patient accounting credit balances, payor overpayments.
• Knowledge of the full revenue cycle process.
• Good interpersonal skills that include the ability to effectively communicate in both writing and verbally.
• Must be detail oriented, function effectively under stress, organized, ability to multi-task and analytical skills required.
• Ability to demonstrate supportive relationships with peers, clients, partners, and corporate executives.
• Must be flexible with a “can do” attitude and have the ability to remain professional under high pressure situations.
• Ability to retain and protect confidential material.
• Able to prioritize customer issues and escalate or solve with urgency

Training and Experience:

• 2 years or more experience in reimbursement and/or accounts receivable setting; hospital or hospital central billing office setting.
• Must be able to follow directions and to perform work according to department standards when no directions are given.
• Computer skills in Microsoft Office applications (i.e., Word, Excel, PowerPoint, etc.) to complete work assigned and AS400 knowledge.  
• Customer Service oriented