Credit Balance Categorization Specialist / Remote

Amerita

The Credit Balance Categorization Specialist (CBS-II) will be responsible for facilitating the resolution of insurance and patient credit balances. The Credit Balance Categorization Specialist (CBS-II) will also work closely with other staff to identify, resolve, and share information regarding payer trends and provider updates.

Shift: Monday-Friday 7:00am-3:00pm

* Ensures daily goals for cash collections, credit balances, medical records, correspondence, appeals/disputes, accounts receivable, and other departmental goals as outlined
* Adheres to all applicable state and federal regulations and company policies
* Maintains insurance contracts in terms of medical policies, payments, patient financial responsibility, credit balances, and refunds
* Verifies professional billed services for dispensed medication and supplies
* Validates reimbursements and appropriate deductible and cost share amounts to the patient
* Reviews remittance advices, payments, adjustments, insurance contracts and fee schedules, insurance eligibility and verification, and assignment of benefits to determine the correct credit classification
* Coordinates offsets and cash research requests with the cash applications department
* Utilizes approved credit categorization criteria to ensure accurate documentation in CPR+
* Creates patient refund packets and validates receipt of previously submitted payer disputes
* Works within established departmental goals and performance metrics
* Identifies and communicates issues and trends to management

High School Diploma or GED; some college desired
• One year of experience in Revenue Cycle Management, Managed Care, Medicare, and Medicaid Reimbursement
• Knowledge of automated billing systems, metric measurements, basic accounting practices, ICD 9/10, CPT, HCPCS coding, and medical terminology; CPR+ and Waystar preferred
• Strong communication, time management, and customer service skills
• Familiarity with Microsoft Office