Credit Balance Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Receive, evaluate, and process refund requests in alignment with payer regulations, internal protocols, and compliance standards.

• Accurately enter and document refund transactions in the billing system, ensuring thorough documentation and audit-ready financial records.

• Investigate account histories to confirm the legitimacy of refunds, payment sources, EOB details, and reasons for overpayments.

• Communicate with attorneys, no-fault carriers, workers’ compensation representatives, and the VA to verify refund information or request necessary documentation.

• Analyze Explanations of Benefits (EOBs) to ascertain justification for refunds and the disposition of payments.

• Partner with Payment Posting, Billing, QA, and Client Services teams to address discrepancies and ensure precise account adjustments.

• Process refunds within designated timeframes while achieving daily productivity targets and service level requirements.

• Keep detailed records of actions taken, communications, and financial adjustments.

• Identify discrepancies, trends, or recurring issues and escalate them to the Department Manager.

• Manage mail, emails, and refund correspondence with appropriate follow-up and documentation.

• Ensure compliance with HIPAA, payer, and internal standards.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• High School Diploma or equivalent.

• Strong aptitude for multi-tasking and managing a high-volume workload while ensuring accuracy.

• Collaborative team player capable of effectively engaging with internal departments and external partners.

• Professional, courteous, and confident demeanor in both verbal and written communication.

• Ability to maintain composure, organization, and focus under pressure.

• High level of computer literacy, including proficiency with dual monitors and navigating multiple systems simultaneously.

• Excellent follow-through and problem-solving skills.

• Strong mathematical abilities and comfort with financial calculations.

• Proficient in reading and interpreting Explanations of Benefits (EOBs).

• Strong attention to detail and dedication to accuracy.

• Capacity to meet deadlines and sustain high productivity levels.

• Prior experience in handling refunds, payment posting, or medical billing is advantageous.

• Reliable, punctual, and accountable with a strong work ethic.

• Ability to independently manage all aspects of the job role, including achieving required goals and business practices in a remote work environment.

🏝️ Benefits

• Competitive salary, commensurate with experience.

• Comprehensive benefits package.

• 401(k) Plan.

• Remote work arrangement.