Credit Balance Specialist - Patient Accounting

Now Hiring: Credit Balance Specialist - Patient Accounting

Build your Career. Make a Difference. Presbyterian is hiring a skilled Credit Balance Specialist to join out team.

Type of Opportunity: Full time

Job Exempt: No

Job is based: Reverend Hugh Cooper Administrative Center

Work Shift: Days (United States of America)

Analyzes and Validates accuracy of all accounts with credit balances to determine whether payments and allowances posted are accurate according to contractual agreements and determines if a refund or an adjustment is required to resolve/close the account.

Some key responsibilities include:

• Performs accounts receivable credit balance reimbursement analysis to determine if reimbursement, allowances, and patient payments received are correct. Must make appropriate adjustments and refer any refunds to the Cash Processing team. Documents accounts in accordance with established PHS policies and procedures.
• Manages the credit balance report and external correspondence relating to overpayments made by insurance payors or patients within established timeframes.
• Responsible for identifying and documenting any insurance payer or internal issues as they arise. Must communicate all issues to teammates and Supervisor or Manager. Responsible for maintaining a file containing all pertinent information for each issue to include correspondence, EOBs, claims, etc.
• Responsible for contacting insurance companies, patients, employers, etc to resolve any over payment issues that require their assistance.
• Must develop positive working relationships and work closely with all outside agencies contracted with Presbyterian, as well as all third party payers to effectively communicate and resolve overpayment issues.
• Must work closely with all PHS departments and teams regarding discrepancies in charges, payments, allowances, etc., posted to accounts.
• Must be an effective team member with good communication and organizational skills. Must participate in team meetings, communicate work related ideas and concerns proactively, and assist in finding appropriate resolutions.
• Adhere to all PHS and Patient Accounting Policies and Procedures to promote a smooth working environment, and uphold PHS Vision by practicing the CARES behavior at all times.
• Cross train in the various patient accounting areas to be completely familiar with all aspects of Patient Accounting functions as they relate to account reconciliation and refunds.
• Performs other duties assigned by the Credit Balance/Refund Supervisor and/or Cash Application Manager.

Qualifications:

• High school degree or GED is required, short-term on insurance follow-up, billing and collections.
• Minimum two years experience in insurance follow-up, billing and collections.
• One year of similar medical facility, physicians office or experience with a major carrier in claims processing preferred.
• Demonstrated ability to communicate effectively via telephone and in writing. Computer literate. Must be able to work closely with co-workers

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Presbyterian Healthcare Services