Credit Balance Specialist - FT - Day - Hospital Billing Lawrenceville NJ

Position Overview

Performs all hospital and professional billing credit balance resolution tasks for insurance and other third-party payors to full completion as assigned by the Credit Balance Resolution Coordinator. Research credit balances, provides supporting evidence, communicates findings and performs billing system adjustment or other necessary actions to resolve credit balances. Prepares, submits, and ensures completion of refunds and retractions where appropriate to resolve credit balances.

Minimum Requirements

• Education: High school diploma or equivalent.
• Experience: One year experience in accounting, finance, or healthcare Revenue Cycle billing operations.

Other Credentials

Possesses knowledge of Revenue Cycle billing functions, such as pre-bill edits, claim submission, accounts receivable or payment posting.

Special Training

Experience working in excel. Experience as an end user in Epic, Athena, or Cerner preferred.

Mental, Behavioral and Emotional Abilities

Ability to take direction, work independently, and meet assigned deadlines. Research.

Reporting Relationships

Does this position formally supervise employees? No

Essential Functions

• Takes direction and supports the Credit Balance Resolution Coordinator with communication and collaboration with billing and cash applications staff if needed.
• Research credit balances and provide supporting evidence, communicates findings and performs billing system adjustments or other necessary actions to resolve credit balances.
• Prepares, submits, and ensures completion of refunds and retractions where appropriate to resolve credit balances.
• Performs billing tasks to resolve credit balances as assigned.
• Reviews host billing systems, cash posting reports, EOBs, claims status documentation, payer portals, and communicates with insurance company customer service representatives for accurate research to determine the cause of credit balances.
• Tracks and trends historical and current credit balance data to help identify potential future credit balance risks.
• Routinely reviews credit balances to identify payment calculation variances with contracts, fee schedule, and claims where appropriate.
• Reviews pre and post applied adjustments to the billing systems in accordance with daily, weekly, and monthly expectations for root cause analysis, corrections, and prevention.
• Supports larger credit balance projects with payer documentation preparation and meeting participation (where needed).

Physical Demands and Work Environment

• Frequent physical demands include: Pinching/fine motor activities, Keyboard use/repetitive motion, Talk or Hear.
• Occasional physical demands include: Standing, Walking, Climbing (e.g., stairs or ladders), Carry objects, Push/Pull, Twisting, Bending, Reaching forward, Reaching overhead, Squat/kneel/crawl.
• Continuous physical demands include: Sitting.
• Frequent sensory requirements include: Accurate Near Vision, Accurate Far Vision, Color Discrimination, Minimal Depth Perception, Minimal Hearing.

Anticipated Occupational Exposure Risks

N/A

This Position Is Eligible For The Following Benefits

• Medical Plan
• Prescription drug coverage & In-House Employee Pharmacy
• Dental Plan
• Vision Plan
• Flexible Spending Account (FSA)
• Healthcare FSA
• Dependent Care FSA
• Retail Savings and Investment Plan
• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
• Disability Benefits – Long Term Disability (LTD)
• Disability Benefits – Short Term Disability (STD)
• Employee Assistance Program
• Commuter Transit
• Commuter Parking
• Supplemental Life Insurance
• Voluntary Life Spouse
• Voluntary Life Employee
• Child
• Voluntary Legal Services
• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance
• Voluntary Identity Theft Insurance
• Voluntary Pet Insurance
• Paid Time-Off Program