- Research, initiate follow-up, and resolve all health care insurance claim accounts with existing credit balances.
Analyze EOBs and/or payor correspondence to reconcile system credit balance or potential overpayments and request adjustments.
Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution of claims
Utilizes excellent written and oral communication skills to collaborate and maintain positive working relationships with peers, leaders, clinical personnel, and payer representatives to resolve credit balances.
Contributes to the implementation of process improvement initiatives aimed at improving the credit department
Qualifications
High School Diploma or equivalent required
Healthcare and medical claim overpayment remediation and refunding experience is required
2-4+ years’ experience with accounting, transactions, or medical billing/accounting systems required
Knowledge or experience working with a variety of health care insurance payers is preferred
Intermediate computer proficiency in Microsoft Office including Excel and Outlook- required
