• Credit Balance Specialist II

    Job Locations US-CO-Centennial
    Job ID
    2018-1511
    # of Openings
    1
    Category
    Accounting/Finance
  • Overview

    The Credit Balance Specialist II (CBS) is responsible for a broad range of collection processes related to medical accounts receivable in support of single and multiple site locations.  The Credit Balance Specialist is responsible for the timely, accurate, and efficient review and analysis of payments and adjustments from insurance payers and patients to determine the accuracy of posting and the validity of remittance advices.  The employee will proactively work assigned accounts to maximize accurate and timely resolution of credit balances. The employee will observe company policies and all applicable laws and regulations.  The employee must have the ability to prioritize and problem solve.  The employee will work closely with other staff to identify, resolve, and share information regarding payer trends and provider updates.  Above all, qualified candidates should possess exceptional internal and external customer service skills and actively promote Amerita’s company culture.

    Responsibilities

    • Insures daily accomplishments work towards company goals for credit balances, cash collections and A/R over 90 days
    • Understands and adheres to state and federal regulations, and to company policies regarding  compliance, integrity, patient privacy and ethical billing and collection practices
    • Understands and adheres to HIPAA and PHI guidelines
    • Understands all aspects of insurance contracts in terms of payments, patient financial responsibility, credit balances, and refunds
    • Reviews residual account balances after payments are applied and generates necessary adjustments (within eligible guidelines), overpayment notifications, refund requests, corrected claims, and secondary billings as needed.  . Assesses and transfers patient balances per remittance advices. 
    • Receives refund and recoupment requests from payers.  Communicates financial concepts pertaining to home infusion contracts, fee schedules, and medical benefits in order to dispute refund requests and recoupments with payers or third party collection agencies
    • Utilizes approved note templates and documents all actions taken in CPR+ for RCM analyst tracking purposes
    • Initiates and coordinates move and cash research requests with the cash applications department
    • Completes credit rebill requests and works with appropriate Billing and/or Collection Specialists when primary claims must be resubmitted as a result of clearing up residual credit balances
    • Utilizes most efficient resources to secure timely resolution of credit invoices or balances; electronic solutions should be given priority
    • Identifies patterns of over payments and brings them to the attention of the appropriate supervisory personnel; identifies billing errors, inaccurate payments, posting errors and resolves accordingly communicating any needed system changes or training opportunities
    • Communicates consistently and professionally with other Amerita employees, payers, and third party collection agencies
    • Adheres to established performance metric for the Credit Balance Specialist
    • Works within specified deadlines and stressful situations
    • Works overtime when necessary to meet department goals and objectives
    • Performs other tasks or special projects as requested by management

    Qualifications

    • High School diploma or GED equivalent required. 
    • College or post-secondary education a plus
    • A minimum of 1-2 years experience in medical collections with a working knowledge of managed care, commercial insurance, Medicare and Medicaid reimbursement;  home infusion experience a plus
    • Working knowledge of automated billing systems, experience with CPR+ and Zirmed preferred
    • Working knowledge and application of metric measurements, basic accounting practices, ICD-9/10, CPT and HCPCS coding
    • Solid Microsoft Office skills required: Word, Excel and Outlook
    • Ability to type 40 wpm and proficiency with10-key calculator
    • Medical Terminology preferred
    • Ability to independently obtain and interpret information
    • Strong verbal and written communication skills; ability to draft/write professional business correspondence 

    Options

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed