Job Title: Account Resolution Specialist
Department: Credit Balance
Location: San Antonio, Texas (on site)
Reports To: Supervisor, Patient Account Services
FLSA Status: Non-exempt

Summary of Position:
To maintain a high and consistent level of support quality across the team and to assist patients, insurance companies and agents via incoming calls regarding patient accounts as well as outbound calls.

Job Responsibilities:
• Evaluate accounts with credit balances and perform processes needed to resolve them
• Evaluate refunds requests from various payers and determine proper action
• Handles incoming call from facilities, patients and insurances and assists accordingly, providing excellent customer service during peak times and/or when team members are out of the office
• Responsible for keeping up with several work queues such as Payment Review, Credit Balance, Urgent Refunds and others as assigned.
• Responsible for the management of several ERMs (Electronic Refunds Management) portals
• Sets up payment plans and take credit card/ACH payments in various payer platforms
• Reviews and works Credit Balance and CSR orders, including urgent refund requests by facilities and patients
• Makes outbound calls to patients to resolve any requests or issues
• Acts as a backup for the Payment Processor position as needed
• Required to meet departmental quality and production standards
• Identify and communicate to department supervisor any areas for improvement across departments
• Acts as backup for electronic fax review and disbursement
• Updates all the information for Business Intelligence reports on a daily basis for CSR, Cashiers and Payment Processing
• Maintain strict confidentiality of patient protected health information (PHI) as mandated by STRG procedures and HIPAA Privacy, Security, and HITECH regulations.
• Contribute to the team culture in a positive manner
• Perform other duties as required

Supervisory Responsibilities:
None

Experience / Skill Requirements:
• Exceptional Customer Service (insurance and patients)
• Exceptional written and verbal communication skills
• Organizational skills, able to prioritize
• Hands on experience in quality assurance
• Minimum of six months’ general office experience with medical insurance background and knowledge of CPT and ICD10
• Computer skills to include Google Suite or similar software
• Type at least 30 wpm and proficient in 10-key by touch
• Ability to read and understand explanation of benefits (EOBs)
• Provide quality customer service - problem solving and decision making
• Must be able to multitask and be a team player
• Maintain confidentiality at all times
• Perform other duties as required

Education:
High School Diploma or GED
Associates degree preferred

Attendance / Work Schedule:
Maintaining and satisfying minimum attendance requirements is an essential function of this position, including working all full-time regular hours as established for this position and scheduled or emergency overtime. Full-time regular hours are defined as Monday through Friday, with after-hours or weekends as required. All employees in this job classification are required to satisfy this requirement. This job classification does not include "light duty" work or allow unpredictable or unrestricted absences.