Credit Balance Analyst

Credit Balance Analyst is responsible for maintaining and assisting with efficient operation of the credit balance department. The individual will support and coordinate the activities of the credit balance for all RCM customers. Additionally, the position supports the company’s overall operations and client services by effectively and efficiently driving the Revenue Cycle Management process and delivering successful outcomes.

Reports To: Director of Revenue Cycle Management

Responsibilities:

• Research and resolve credit balance claims.
• Navigate payer and internal systems for timely resolution of credit balances.
• Drive results, continuous improvement, and growth.
• Maintain positive relationships with customers, teammates, and payer representatives.
• Adhere to all relevant policies, laws, and regulations.
• Review and research credit balance accounts daily.
• Prioritize workload based on credit balance status and payer correspondence.
• Perform root cause analysis on overpayment trends.
• Research each credit balance for refund, cash posting error, or correct payment.
• Utilize payer resources to resolve credit balance issues.
• Notify management of payer trends and issues contributing to credit balances.
• Review overpayment details for accurate refunds.
• Resolve offset accounts when refunds have been issued.
• Coordinate refund requests and credit transfers.
• Participate in special projects and other duties as assigned.

Qualifications:

• 3 years of revenue cycle experience, preferably with reimbursements and credit balances.
• Proficiency in Excel and strong computer skills.
• Knowledge of HIPAA guidelines.
• Strong communication, problem-solving, and analytical skills.
• Team-oriented, detail-oriented, organized, and personable.
• Experience with complex billing, claims processing, and reimbursement issues.
• Ability to adapt to a changing environment and solve problems with minimal supervision.
• Thorough knowledge of general healthcare A/R and billing procedures.
• Experience in depicting appropriate payment from fee schedules and EOBs.