Credit Balance Specialist

Qualifications:
Qualifications: Education: • Associate's Degree in a related field or equivalent combination of training and experience is required. Preferred/Desirable: • Bachelor's Degree in a related field preferred. Experience: • Four or more years related experience in a healthcare field is required. Preferred/Desirable: • Two or more years in refund check processing is strongly preferred. • Three or more years in Claims processing desirable. Certification or Conditions of Employment: • Pre-employment background check Competencies, Skills, and Attributes: • Effective collaborative and proven process improvement skills. • Strong oral and written communication skills; ability to interact within all levels of the organization. • A strong working knowledge of Microsoft Office products. • Demonstrated ability to successfully plan, organize and manage projects. • Detail oriented, excellent organizational skills. Working Conditions and Physical Effort: • Regular and reliable attendance is an essential function of the position. • Ability to work OT during peak periods. • Work is normally performed in a typical interior/office work environment. • No or very limited physical effort required. No or very limited exposure to physical risk.

Responsibilities:
Job Summary: Processes all Credit Balance provider-reported refunds in Facets and responds to all provider inquiries. Investigates, processes and tracks all provider Credit Balance refund checks and records in QuickBase as necessary. Researches and compiles recovery leads for COB and TPL. Serves as an internal resource for the External Auditors by providing them with information not available in the field and by assisting them with their retractions when possible. Key Functions/Responsibilities: • Tracks, documents and processes all provider refund checks. Ensures that QuickBase is updated appropriately. Returns incorrect refunds to providers. Works with Finance to ensure that checks are deposited appropriately and in a timely manner. • Ensures that all credit balance adjustment requests are processed accurately and in a timely manner in Facets. • Serves as key contact for all provider-related Credit Balance telephone calls. • Interfaces with other departments at BMCHP such as OPL to identify potential COB or TPL cases. Identifies training issues or provider trends and reports findings to the OPL Manager. • Develops and maintains Credit Balance document retention policies. • Assists in the development and implementation of departmental policies and procedures.