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Credit Balance Resolution Specialist I - Orlando Health Medical Group - Day Shift

 

Credit Balance Resolution Specialist I - Orlando Health Medical Group - Day Shift - Orlando Health Heart Institute

Position Summary

The Credit Balance Resolution Analyst focuses on resolving creditbalance issues. The Credit Balance Resolution Analyst reviews data to determinethe corrective action needed and submits appropriate documentation to bring theaccount to resolution.

Education/Training

High school or GED equivalent required.

Intermediate computer skills andproficiency in Microsoft Office Suite, specifically Word and Excel.

Experience

Two (2) years experience in a relatedfield (medical billing/collections/managed care/accounting).

Ability to perform 10-key by touch.Ability to perform both written and verbal communication skills effectively.

Ability to perform routine mathematical function.

Essential Functions

Determines if the payments received arecorrect and then determines the appropriate steps for resolution, including(but not

limited to) refund payment, transfer, and adjustment.

Review entire guarantor record toidentify accounts across all facility locations with open patientresponsibilities and transfers

patient payments when appropriate.

Key and/or import refunds and paymenttransfers accurately into the designated Patient Accounting system daily.

Apply credit balance reconciliationchanges and updates according to any internal or regulatory guidelines at thefederal, state, and

local levels.

Coordinate and collaborate with PatientAccounting areas for proper information and communication when resolving credit

balances.

Verify and update insurance whennecessary to assure correct contractual adjustment is applied.

Effectively and accurately utilize thecomputer system to enter appropriate information.

Reconcile refund entries on patientaccounts to A/P checks processed; correct any errors and obtain properauthorization for any

refund processed.

Report trends and issues identifiedduring account analysis to management for additional review and resolution;including those

relating to payment posting, billing, payer reimbursement, andcompliance.

Maintain necessary logs and monthlyperformance standards to assure department goals are met.

Maintain reasonably regular, punctualattendance consistent with Orlando Health policies, the ADA, FMLA and otherfederal, state

and local standards.

Maintain compliance with all Orlando Healthpolicies and procedures.

QUALIFICATIONS:


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