- Account Analysis: Conduct detailed reviews of patient account credit balances to identify necessary transactions, including refunds, adjustments, or corrections.
- Compliance & Research: Apply insurance-specific rules and healthcare policies to calculate accurate refund amounts, ensuring all actions meet federal and state regulations.
- Dispute Resolution: Coordinate with insurance companies to resolve discrepancies, verify COB (Coordination of Benefits), and reconcile account mismatches.
- Data Management: Pull facility-specific reports, maintain meticulous records of refund statuses, and process refund invoices for overpayment cases.
- Unclaimed Property: Identify and report unclaimed property related to credit balances in accordance with state laws.
- Collaboration: Act as a resource for department managers and mentor less experienced staff as needed.
- Experience: 2+ years of direct experience specifically within Credit Balances and Refunds.
- Hands-on experience with insurance portals (e.g., UCH, Availity, Optum).
- Intermediate proficiency in Microsoft Excel and Outlook.
- Core Competencies: * Expertise in reading and interpreting EOBs.
- Strong understanding of insurance coinsurance and payment posting processes.
- Ability to multitask in a fast-paced, high-volume environment without sacrificing accuracy.
- Experience using SharePoint or Waystar
- Previous background in Payment Posting.
- Work-Life Balance: Enjoy the flexibility of a fully remote schedule after your initial 30-day training period.
- Growth Opportunity: This position is open due to organizational growth, offering a stable environment with a clear mission.
- Direct Impact: Your work ensures financial integrity for our patients and compliance with critical healthcare regulations.
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Credit Balance Specialist - 250002 - Houston - Medix™
Description
*** Must be local to the Houston area ***
Location: Fully Remote (After 30 days of onsite training)
Schedule: Monday–Friday | 8:00 AM – 5:00 PM or 7:00 AM – 4:00 PM
Pay Rate: Up to $23.00/hour (Based on experience)
Position Overview
We are seeking a detail-oriented Credit Balance & Refund Specialist to manage the lifecycle of patient and insurance overpayments. In this role, you will be the "financial detective" of our patient accounts—meticulously researching payment histories, interpreting complex Explanation of Benefits (EOBs), and determining the correct course of action for refunds or corrections.
This is a growth-oriented role perfect for a candidate with a strong background in healthcare revenue cycle management who enjoys high-volume, analytical work.
Key Responsibilities
Required Qualifications
Preferred Skills
The "Why" Behind This Role
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