Job Details

Overview

Join to apply for the Hospital Credit Balance Specialist role at United Surgical Partners International, Inc.

Responsibilities

• Manage daily work queues of credit balances for both onshore & offshore teams.
• Research, initiate follow-up and resolve all health care insurance claim accounts with existing credit balances.
• Complete thorough review of patients accounts with credit balances to validate the patient overpayment is accurate.
• Recommend an adjustment when applicable or recommend a refund of the overpayments to the insurance carrier or patient, providing the appropriate documentation.
• Apply knowledge related to insurance contracts, interpret explanation of benefits, understand regulations concerning coordination of benefits and other applicable guidelines.
• Process refunds accurately and in timely manner adhering to contract language where appropriate.
• Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution of claims.
• Use critical and analytical problem-solving skills to resolve issues.
• Use strong organizational skills to effectively manage large amounts of detailed information.
• Utilize excellent written and oral communication skills to collaborate and maintain positive working relationships with peers, leaders, surgery centers, and payer representatives to resolve credit balances.
• Consistent, regular, punctual attendance as scheduled is an essential responsibility of this position.
• Other duties as assigned.

Qualifications and Experience

• High school graduate or equivalent.
• Must have the skills necessary to operate the office equipment required to fulfill job duties.
• Experience with Excel, Word, Outlook.
• Able to navigate through nThrive and Availity (preferred).
• Previous credit balance resolution experience in a facility or CBO environment.
• 2 years combined experience in CBO in Billing, Cash Collections, Denials, Disputes, Follow-up, and/or appeals.
• Understanding of medical terminology.
• Basic understanding of credit and refund guidelines.
• Additional Notes: This is not an all-inclusive list. Additional tasks and responsibilities may be added by management based on business need.

Job Details

• Seniority level: Entry level
• Employment type: Full-time
• Job function: Finance and Sales
• Industries: Hospitals and Health Care