Credits Specialist

Overview

• The Credit Resolution Escalation Specialist is responsible for the monitoring and resolving Credit balances and refunds from billing system’s overages. Daily assignments are provided by the supervisor and the Credit Resolution Escalation Specialist must develop a plan to complete work lists by the end of each day. The Credit Resolution Escalation Specialists must comply with applicable laws regarding billing standards and be able to operate in a team-oriented environment that strives to provide superior service to our providers throughout the country.

Responsibilities

• Processes, research, and resolves credit balances and refunds from a billing system’s overages that are escalated from the Credit team.
• Reviews refund request letters and determines an appropriate resolution based on contract and timely guidelines.
• Identifies trends and notifies appropriate departments.
• Ensure that all check registers are sent to Client Success or finance for Approval.
• Ensure we receive all check numbers from Client to be uploaded into the system to ensure Credits can be cleared.
• Ensure all returned refund checks are researched and corrected.
• Analyze data from various reports and makes recommendations accordingly.
• Performs special projects and other duties as assigned.

Qualifications

• High School Diploma or Equivalent.
• Two (3) year of experience posting insurance payments in a healthcare setting.
• Two (3) years of experience reading insurance Explanation of Benefits (EOB) statements preferred.