Credit Resolution Specialist

The Credit Resolution Specialist is responsible for accurately analyzing and performing the appropriate disposition of all revenue cycle credit balances and refund requests. Working under minimal supervision, this role ensures that the disposition of credit balances are completed as defined in all Contractual, Regulatory and Corporate Compliance requirements.

Essential Job Function

• Analyzes account credit balances for accuracy, ensuring compliance with regulatory laws and hospital contracts.
• Reviews and processes self-pay and insurance refunds within specified time frames, posts adjustments accurately, Promptly responds to correspondence regarding patient accounts, evaluating priorities and organizing time to ensure timely completion of required activities.
• Follows procedures for documenting, verifying, and processing refund requests, ensuring accuracy before submission.
• Maintain acceptable level of quality and production standards as determined by supervisory review and audit of assigned account categories.
• Notifies manager of possible or potential issues that may result in delays in processing credit balances
  
  Accurately identifies all credit balances that must be reported to government agencies.
• Prepares and submits the credit balance logs quarterly as mandated by federal /state regulations.
• Maintains a working knowledge of payor reimbursement and associated reimbursement policies.
• Performs other duties as assigned.

• Required:
  
  High School Diploma or equivalent

• Required:
  
  3 Years

Required

Preferred

Job Industries

• Other