Credit Resolution Representative, II – PFS

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

📋 Description

• Manage credit account balances from patients and insurance companies within hospital and/or medical group revenue operations.

• Evaluate, oversee, and follow up on insurance, patient, and Medicare credit accounts receivable.

• Identify root causes of credit balances and take necessary actions to resolve accounts completely.

• Record payments and insurance denials, and resubmit claims as required.

• Log corrections, discrepancies, outstanding items, exceptions, rejections, and follow-up actions in the designated systems.

• Monitor payment activity and findings for the Supervisor.

• Execute account adjustments or write-offs per policy guidelines.

• Investigate credit balances resulting from payment postings and compile documentation.

• Provide constructive feedback to the Cash Posting team.

• Act as a backup to Payment Posting Representatives.

• Prepare refund checks for patients and insurers, entering data into the appropriate system.

• Encourage precise cash posting and reconciliation.

• Timely and effectively post incoming payments.

• Submit, monitor, analyze, and report related cash-posting processes to key stakeholders.

• Stay informed about relevant laws, regulations, and Trinity Health’s Integrity and Compliance Program, Code of Conduct, policies, and procedures.

• Report directly to the Supervisor of Payment Posting.

⛳️ Requirements

• High school diploma or Associate's degree in Accounting, Business Administration, or a related field, along with up to three (3) years of relevant experience in revenue cycle functions and systems, preferably within a hospital or clinic, health insurance company, managed care organization, or other healthcare financial service setting, including medical claims processing, financial counseling, financial clearance, accounting, or customer service activities, or an equivalent combination of education and experience.

• Proficient in Microsoft Office Suite, including Outlook, Word, PowerPoint, and Excel.

• Exceptional written and verbal communication skills, along with strong organizational capabilities.

• Excellent interpersonal skills for engaging with both internal and external customers.

• High degree of accuracy, attention to detail, and effective time management skills.

• Completion of regulatory/mandatory certifications and skills validation competencies is preferred.

• Ability to thrive in a collaborative, shared leadership environment.

• Must demonstrate personal characteristics of honesty, integrity, and compassion, with the ability to inspire and motivate others to uphold Trinity Health’s philosophy, mission, vision, goals, and values.

• Must be able to adhere to Trinity Health policies and procedures.

🏝️ Benefits

• Comprehensive health coverage including medical, dental, and vision.

• Retirement savings plan with employer match.

• Generous paid time off and holiday schedule.

• Opportunities for professional development and advancement.

• Employee wellness programs and support services.