Description
FLEX TEAM Credits Remediation
.*The manager is looking for someone who can review HB and PB accounts and determine the appropriate action to take. For example: We have a credit on an account due to a cost share collection; however, no charges to match. We have documented scenarios and this person must be able to identify the scenario for this account and take appropriate action based on the scenario documentation.*
Within Policies and Procedures, and under direct supervision of Managers, these FLEX team resources will be responsible for reconciling aged credit balance accounts for all lines of business; determining disposition and resolving credit balances.
- Researches and follows up on all credit balance accounts for all lines of business.
- Identifies and reconciles accounts to be escheated to the local, state and/or federal authority(s) to comply with regulatory requirements.
- Reviews HealthConnect work queues to determine proper course of action for credit balance resolution by preparing or reversing adjustments, initiating refund requests, reversing charges and requesting transfers if applicable.
- Analyzes explanation of benefits, attorney, insurance and other confidential documentation, including patient statements.
- Escalates any identified trends to department analyst and/or supervisor.
- Facilitates account resolution by corresponding with appropriate parties for resolution of credit accounts via telephone, email and/or US postal mail.
- Distributes and undistributed funds as appropriate.
- Identifies missing charges.
- Analyzes credit balances and computations.
- Consistently supports compliance and the Principles of Responsibility by maintaining the privacy and confidentiality of information, protecting the assets of the organization, action with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations accreditation and licenser requirements (if applicable), and Client's policies and procedures.
Healthcare Experience
Healthcare Billing and Collection Experience
Epic HB and/or PB is preferred
Ability to reconcile account detail
Ability to identify a credit, and its root cause
Ability to effectively communicate an opportunity for improvement
Understand accounting standards and principals
Understanding of compliance and regulatory requirements within healthcare