Credit Balance & Refund Representative
Job Type :
Required Years of Experience :
Job Industry :
Job Description :
The Credit Balance & Refund Representative is responsible for analyzing credit balances to determine the cause of the credit balances; facilitates account resolution of credit balances. The position requires professional Customer interaction and adherence to MEDHOST best practice methodologies.
• Responsible for analyzing insurance and patient payments posted to patient accounts.
• Understands all aspects of payor contracts in terms of payments and refunds.
• Utilizes appropriate software and reporting to identify all credit balances and determine action for refunds.
• Monitors and reports to leadership of any trends identified and document credit balance/refunding issues.
• Identifies overpayments and requests refunds to the appropriate party assuring compliance with hospital policies and procedures.
• Process refund and adjustment requests 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.
• Generates credit balance/refunding reports for customers.
• Develop workflows to improve internal process and efficiency.
• Assist other team members when necessary.
• Accurately enters and submits time by the required departmental deadlines
• Books travel in adherence to the company travel policy
• Maintain and update 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 the MEDHOST 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 in a timely fashion
• Ensure that all HIPAA Privacy and Security requirements and responsibilities are adhered to constantly
• Assists the leadership team in evaluation of team skills and recommend improvements
• All other duties as assigned
Required Qualifications :
Knowledge, Skills and Abilities:
• Basic knowledge of business office terminology.
• Proven ability to understand and interpret reason for patient accounting credit balances, payor overpayments.
• Knowledge of the full revenue cycle.
• 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
• Negative pre-employment drug tests
• Criminal and MVR backgrounds meet our company hiring criteria