Chicago-North suburbs
The Credit Resolution Specialist is responsible for accurate and timely credit resolution for patient accounts and client invoices. The Specialist utilizes revenue cycle system reports, client invoices, and payer refund requests to determine the nature of the credit balance or appropriateness of the refund to resolve credits or process refunds. The Specialist adheres to payment posting, adjustment, credit balance, and refund standard operating procedures in addition to following government and insurance payer guidelines.
Essential Job Functions:
• Analyzes account credit balances to identify action for account resolution. Utilizes system reports, researches payments, and analyzes accounts to resolve credit balances or generate refund.
• Corrects or modifies system transactions to resolve credit balances or apply an insurance refund. Notates patient account of action taken.
• Researches patient and insurance refund requests for appropriateness. Initiates refund with Finance or appeals refund request directly with payer.
Bachelor’s degree in healthcare, business, or finance preferred.
• 4 – 5 years of experience in accounts receivable or cash applications within a revenue cycle or business office.
• 3 + years of experience with CMS1500 claims form and insurance payer explanation of benefits or 835 electronic transaction sets.
• 2 – 3 years of experience working in revenue cycle applications to resolve patient accounts.