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Credit Resolution Representative

PWW Recruiting, LLC.

Credit Resolution Representative

Grand Rapids, MI
Full Time
Paid
  • Responsibilities

    overview

    Job Requirements:

    -High school diploma or Associate's degree in Accounting or Business Administration

    with at least two (2) years of experience and relevant knowledge of revenue cycle

    functions and systems within a hospital or clinic environment, a health insurance

    company, managed care organization or other health care financial service setting,

    performing medical claims processing, financial counseling, financial clearance,

    accounting, or customer service activities or an equivalent combination of education

    and experience. Some knowledge of health insurance and governmental programs,

    regulations, and billing processes, e.g., Medicare, Medicaid, Social Security Disability,

    Champus, Supplemental Security Income Disability, managed care contracts and

    coordination of benefits is highly desired. Experience in a complex, multi-site

    environment preferred.

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

    -Excellent written and verbal communication skills and organizational abilities.

    -Strong interpersonal skills in interacting with internal and external customers.

    -Strong accuracy, attention to detail and time management skills.

    -Completion of regulatory/mandatory certifications and skills validation competencies

    preferred.

    -Must be comfortable operating in a collaborative, shared leadership environment.

     

     

    What you need to know:

    Performs day-to-day activities required to process credit account balances from patients and insurances within the Hospital and/or Medical Group revenue operations ($3-5B NPR) of a Patient Business Services (PBS) location. Serves as a member of a team at an assigned PBS location responsible for reducing patient balance account receivable credits and coordinating with the customer service team to communicate to patients regarding overpayments. Responsibilities require expertise in determining the root cause of credit balances and in taking the appropriate steps to resolve issues resulting in full adjudication of an account. Work activities include posting patient balance refunds and rebilling claims as needed to maintain manageable credit accounts receivable and to ensure accurate submission of claims and patient statements. This position reports directly to the Supervisor Payment Posting.

    key qualifications

    minimum education

    High School/GED, Associates

    years experience

    2+ years

    schedule details

    5 days/week

    perks

    Professional development opportunities

    Full benefits