Credit Specialist

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

📋 Description

• Conduct research on credit balances associated with patient accounts for both patients and payers.

• Examine each credit balance to ascertain whether an overpayment has occurred.

• Identify the appropriate actions to take in order to address refund requests or credit balances.

• Complete and submit refund requests to the refund department.

• Request necessary payment corrections or adjustments as required.

• Initiate the transfer of patient payments to other accounts that have outstanding balances.

• Notify payer representatives to start the recoupment process and provide necessary documentation.

• Execute payment or adjustment corrections as needed.

• Manage the transfer of patient payments to other accounts with pending balances.

• Ensure thorough, accurate, and timely account notes and documentation are maintained in EPIC.

• Prepare refund tasks in EPIC for processing payor/patient refund requests.

• Review and follow up on refund/offset requests to guarantee timely completion.

• Contribute to processes aimed at improving workflows for credit balances.

• Oversee daily credit-balance work queues to ensure prompt resolution of accounts.

• Conduct regular reconciliations of patient accounts.

• Investigate and resolve any discrepancies or disputes concerning patient accounts.

• Ensure adherence to credit-balance review protocols, as well as CHN and affiliate policies, alongside state and federal regulations.

• Perform clerical tasks that support daily operations.

• Show commitment to CHN and Planned Parenthood’s mission of health equity, racial equity, and accountability to the community.

• Engage in learning and enhancing practices related to racial equity and addressing structural racism within healthcare systems.

• Offer constructive and developmental feedback regarding equity practices.

⛳️ Requirements

• At least 3 years of experience in relevant accounts receivable roles.

• Solid understanding of the coordination of benefits.

• Experience with account inquiries and analysis to evaluate payment methodologies and accuracy is required.

• Clear comprehension of contract terms, payer policies, and a strong grasp of explanation of benefits.

• Strong analytical and problem-solving skills.

• Proficiency in Microsoft software, particularly Excel.

• Ability to maintain a customer-centric service approach in a dynamic environment.

• Excellent written and verbal communication skills, with the capability to collaborate and engage with individuals at all levels within and outside of CHN when needed.

• Strong attention to detail and follow-through, along with the capacity to multitask in a fast-paced setting.

• Proven commitment to Planned Parenthood’s mission, vision, and values.

• Strong interpersonal skills and the ability to cultivate relationships with stakeholders.

• Excellent time management and problem-solving capabilities.

• Commitment to promoting race (+) equity in their work, with an interest in broadening knowledge about the impact of inequity in society.

• Preferred: proficient use of Excel, Word, and a Windows environment; experience with Epic, eCW, NextGen, or other practice management systems is advantageous.

• Medical Billing and Coding certification is a plus.

🏝️ Benefits

• Health Care Coverage (Medical, Dental, & Vision); available to full-time, regular employees from the date of hire.

• Flexible Spending Accounts and Health Savings Account options.

• Short-Term Disability and Basic Life & AD&D Insurance provided by CHN.

• Voluntary options for Long Term Disability and Additional Life & AD&D Insurance available at cost.

• Employee Assistance Program.

• Retirement Plan with a 3% employer match after one year of service.

• Paid Time Off Program includes accrual-based PTO, Health Time Off (HTO), and nine (9) paid Holidays.