Job Summary and Responsibilities

As a Credit Balance Refund Representative, you will resolve insurance and patient credit balances, issuing and requesting refunds to ensure patient satisfaction and regulatory compliance.

Every day you will ensure timely and accurate resolution of all credit balance accounts, identifying if refunds, payment transfers, or adjustments are needed through thorough account research.

To be successful in this role, you will apply your understanding of billing requirements and insurance follow-up practices, demonstrating attention to detail and efficient problem-solving for refund issues.

• Reviews and analyzes accounts and/or reports from insurance companies and patients to facilitate the resolution of credit balance accounts.
• Reviews accounts and/or reports, including: Explanation of Benefits (EOB)/ Electronic Remittance Advice (ERAs), payments, adjustments, insurance contracts and contracting system, insurance benefits, and all account comments; contacts and communicates with insurance companies to gather additional information, as necessary.
• Refunds overpayments on accounts and transfers payments to the appropriate accounts.
• Verifies all patient account charges are billed to the insurance plan.
• Validates that insurance has paid correctly and identifies any patient responsibility.
• Conducts appropriate review to accurately transfer payments in accordance with established procedures.

Job Requirements

Required

• Two years of revenue cycle or related work experience that demonstrates attainment of the requisite job knowledge and abilities or
• Other Post-high school education in a field (e.g. medical billing) that would demonstrate attainment of the requisite job knowledge/abilities may be substituted.