Credit Specialist Job Henderson area,Nevada USA,Healthcare

This position is Remote in PST and CST. You will have the flexibility to work remotely
* as you take on some tough challenges.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.

Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Credit Specialist researches and resolves patient and insurance credit balances within the healthcare revenue cycle. This role reviews account activity, remittances, and supporting documentation to determine why a credit exists and how it should be resolved. The specialist initiates refunds, processes transfers and adjustments in the billing system, documents findings, and routes refund transactions for required review and approval. The role works with internal teams to resolve discrepancies and prevent incorrect refunds.

This position is full-time (40 hours/week) Monday
- Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 5:00 pm PST. It may be necessary, given the business need, to work occasional overtime.

We provide up to 6 weeks of training aligned to your schedule. Training will be conducted virtually

Primary Responsibilities:

Research patient and insurance credit balances by reviewing payment history, adjustments, remittances, correspondence, and supporting documentation.
Identify the cause of a credit, including duplicate or excess payments, payment posting errors, reversals, payer recoupments, or changes in patient or insurance responsibility.
Determine the appropriate resolution of a credit, such as a patient refund, payer refund, transfer, or adjustment, in accordance with established policies and procedures.
Initiate refund transactions in Epic, verifying the amount, recipient, and supporting documentation before submitting them for required review and approval.
Research payer over payments, including government payer over payments, and follow applicable refund and documentation workflows.
Review account information for discrepancies or conflicting payer information. Refer issues requiring correction or further validation to the appropriate team before proceeding with a refund.
Process account transfers and adjustments, and document the research, actions taken, and resolution in the billing system.
Respond to internal inquiries regarding credit balances, refunds, and account activity. Coordinate with billing, follow-up, payment posting, Finance, Treasury, and other partners as needed.
Identify and route eligible unclaimed credits through the established escheatment process.
Maintain accurate account notes and supporting records while meeting established productivity, quality, and turnaround expectations.
Identify recurring causes of credit balances and communicate account findings or workflow issues to the supervisor

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

High School Diploma/GED or equivalent work experience
Must be 18 years of age OR older
2+ years of experience in accounts receivable, billing, credit balance resolution, or a related financial transaction role in healthcare field
Experience with Microsoft Office applications, including Microsoft Excel
Ability to work full-time (40 hours/week) Monday
- Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 5:00 pm PST. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

Experience in healthcare revenue cycle, medical billing, or credit balance resolution
Experience with payment posting, including reviewing ERAs, EOBs, payments, and adjustments
Experience researching patient and insurance over payments and initiating refunds
Epic experience

Telecommuting Requirements:

Reside within Pacific Time Zone and Central Time Zone
Ability to keep all company…