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    • Credit Balance - Charleston - Advanced Urology Institute LLC

    Advanced Urology Institute LLC
    Advanced Urology Institute LLC Charleston

    3 weeks ago

    Default job background
    Full time
    Description

    Job Title

    Credit Balance and Refund Specialist

    Job Summary

    The Credit Balance and Refund Specialist is responsible for investigating and resolving credit receivable balances. This includes properly adjusting incorrect data entries or processing refunds when appropriate, in alignment with management policies and procedures.

    This role involves meeting or exceeding daily/weekly/monthly productivity targets set forth by management.

    Key Responsibilities

    1. Identify and research credit balances to separate true credits from false credits.
    2. Review patient and guarantor account(s) to ensure a credit cannot be applied to an alternate balance on an account.
    3. Process patient refunds in accordance with policies for true credits when appropriate.
    4. Correct data entry errors that generated false credits and communicate trends to management.
    5. Follow established protocols for approval of refunds.
    6. Batch refunds and provide them to the Finance department for processing as directed by management.
    7. Conduct regular follow-up on the processing status of refunds with the Finance department.
    8. Address/resolve issues relating to patient accounts while noting account actions for a complete audit trail of follow-up activity.
    9. Communicate with the Payment Posting Specialist, Claim Resolution Specialist, and Business Office staff when necessary to resolve errors and clarify issues.
    10. Maintain accountability to quality and productivity standards and monitor compliance with policies and procedures.
    11. Identify process opportunity trends and recommend ways to improve efficiencies.
    12. Ensure adherence to third-party and governmental regulations relating to coding, billing, documentation, compliance, and reimbursement.
    13. Participate in special projects, personal development training, and cross-training as instructed.
    14. Inform Supervisor of trends, inconsistencies, discrepancies for immediate resolution.
    15. Collaborate with peers and functional areas of the Business Office department for the betterment of completing tasks and the company overall.

    Requirements

    • License and certification as required by state.
    • Demonstrates understanding of business and how actions contribute to company performance.
    • Demonstrates excellent customer service skills.
    • Knowledge of medical terminology, healthcare coding systems, and clinic functions.
    • Experience in the use of CPT and HCPCS required.
    • Utilizes Practice Management (PM) system and all other software systems in accordance with Business Office and/or management protocols.
    • Able to follow policies and procedures for compliance, medical billing, and coding.
    • Able to type and enter data with proficiency and accuracy.
    • Proven ability to manage multiple projects at a time while paying strict attention to detail.
    • Able to successfully meet departmental deadlines.
    • Excellent verbal and written communication skills.
    • Strong analytical and problem-solving skills.
    • Customer-oriented with ability to remain calm in difficult situations.
    • Skill in using computer programs and applications including Microsoft Office.
    • Able to work independently and manage deadlines.
    • Complies with HIPAA regulations for patient confidentiality.
    • Complies with all health and safety policies of the organization.

    Education Requirements

    • High School Diploma or equivalent required.

    Experience Requirements

    • Minimum 2 years experience within a physician's office or medical environment.
    • Experience in Urology physician practice environment preferred.
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