Credit Balance Specialist - Patient Accounting - Full-Time

The Credit Balance Specialist compiles appropriate billing module reports in order to review all existing credit balance accounts. Analyzes and resolves issues pertaining to credit balances, including review of reminders from billers, payments, adjustments, and written requests for refunds before preparing appropriate documents for management review and approval. Makes follow-up phone calls to insurance companies or policyholders whenever necessary regarding credit balances or overpayments. Resolves credit balances by completing refund documents for management review. Mails refund checks, notes accounts, and keeps copies of documentation available for auditors. Responsible for resolving reminders assigned to Patient Accounting in order to bring accounts closer to completion. Answers all patient or insurance company calls regarding status of refund or other issues. Responsible for monthly review and adjustment of various special reports including but not limited to: bariatric, SPOB, financial assistance, charity care, SPLSU, circumcision and others as necessary.

Requirements:

• High school diploma or equivalent.
• Two years in hospital billing and collections, managed care, CHAMPUS, or Medicare/Medicaid methodology

Responsibilities:

• Work daily self-pay and insurance reports to resolve previous day credit balances. Make appropriate notes on accounts so that current status of balance is clear. Set future follow up review if necessary or forward to other staff if appropriate for resolution.
• Reviews special reports monthly for A/R and Billing Managers including but not limited to: bariatric report, SPOB, financial assistance, circumcision, and credit balance no longer due reports. Resolve per procedures on each.
• Reviews requests for refund (by staff or by correspondence), processes refund request responses to correspondence received within 24 hours of receipt.
• Contacts insurance companies to resolve credit balances according to established guidelines.
• Accurately prepares a Refund Adjustment form according to current procedure once refund amount is confirmed.
• Reviews daily worklist in Huron of assigned WOMEMP (employee accts) for follow up; refiles accounts as necessary or works with Human Resources to ensure employee claim is processed as needed. Processes weekly adjustment file for additional review on accounts, applies EMP discounts if needed and bills patient for balance.
• Runs daily listing of reminders in Meditech through current date, sorting by reminder type. Works all PT reminders as priority, other as time allows. PT reminders are to be resolved within three days from sent date. This includes but is not limited to employee, PHY, VOL and other special reminder classifications that require review.
• Utilizes Imaging tools when necessary to support overpayment or confirm source of payment. Attaches copies of support from primary and secondary or alternate payors to refund requests if necessary for review by Manager or Controller. Makes notes on account that refund request has been forwarded to Manager for audit trail. Ensures patient confidentiality by obscuring names and other personal information on bulk EOBs.
• Receives refund checks from Accounting department. Retains appropriate documentation in files by forwarding copies of checks and journal summary to file clerks who will create a scanned batch. Mails refund check with attachment copies on same business day. Enters comment into system noting that check has been mailed, or runs comment script to note accounts.
• Any other duties as assigned by Woman's Hospital.

Schedule:

Full-Time; Monday - Friday

7:30 AM - 4:00 PM

Pay Range:

Hourly/Non-Exempt

$15.00 - $21.00; based on work experience

A Work Experience with Purpose

Woman's is one of the largest specialty hospitals for women and infants in the United States. We are recognized throughout the country for our innovative programs, and we pride ourselves in surpassing the expectations of those we serve. Providing exceptional patient care and creating exceptional patient experiences are at the center of what we do at Woman's. Our team consistently exceeds state and national benchmarks for patient satisfaction.

Our employees, organizational culture, mission, vision, values, and benefits make Woman's a best place to work. In fact, for the 17th year in a row, Woman's has been recognized as a Best Place to Work by Modern Healthcare - making us the only healthcare organization to earn the distinction every year since the program's inception. We are proud of the level of care our staff provides to our patients and each other.

If you have any questions or would like to connect with one of our recruiters directly, please e-mail hrjobs@womans.org.

Woman's Hospital is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law.