Credit Balance Specialist

Job Description

Job Description

Established in 2001, Southeast Orthopedic Specialists is a regional leader in orthopedic medicine. We are dedicated to growing with our patients. Our reach will continue to expand to meet the needs of all patients, present and future. It is our wish to make industry-leading five-star orthopedic care accessible to as many people as possible.

Healthcare Outcomes Performance Company is a vertically integrated musculoskeletal outcomes management company. HOPCo is the managing partner Florida-based Southeast Orthopedic Specialists.

As Southeast Orthopedic Specialists continues to grow, we are looking for a Credit Balance Analyst.

Please see below for the functions and requirements to be a Credit Balance Analyst with Southeast Orthopedic Specialists.

ESSENTIAL FUNCTIONS

• Handles all patient communication regarding refunds.
• Investigates and resolves reconciliation discrepancies for patient accounts.
• Thoroughly researches credit balances to determine if an overpayment occurred and initiates the refund process accordingly outlining the reason for the refund and including EOB’s if necessary.
• Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients.
• Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement from insurance payers.
• Assumes full responsibility of reducing the accounts receivable of insurance and patient credit balances by working through outstanding accounts.
• Analyzes accounts for proper claims processing and payment posting through inquiries from patients or staff.
• Identifies and communicates trends and/or potential issues to management team.
• Follows and maintains all CORE Institute policies and procedures, including those specific to billing and the Business Office.

EDUCATION

• Minimum High School Diploma or equivalent

EXPERIENCE

• Minimum two to three years of experience in medical billing. Must be able to communicate effectively with physicians, patients and the public and be capable of establishing good working relationships with both internal and external customers.

REQUIREMENTS

• None

KNOWLEDGE , SKILLS AND ABILITIES

• Knowledge of the physician billing processes, ICD-10 and CPT coding.
• Knowledge of computer systems. Experience with GE patient management system preferred.
• Advanced computer knowledge, including Window based programs.
• Skill in customer service and an understanding of The CORE code of conduct and culture.
• Skill in using computer programs and applications including Microsoft Excel, Microsoft Word and Outlook.
• Skill in establishing good working relationships with both internal and external customers.
• Ability to multi task in a fast paced environment. Must be detailed oriented with strong organizational skills.
• Ability to understand patient demographic information and determine insurance eligibility.
• Ability to work independently and demonstrate the ability to analyze data.

ENVIRONMENTAL WORKING CONDITIONS

• Normal clinic environment

PHYSICAL/MENTAL DEMANDS

• Requires sitting and standing associated with a normal office environment.
• Some bending and stretching required.
• Manual dexterity using a calculator and computer keyboard.

ORGANIZATIONAL REQUIREMENTS

• HOPCo Mission, Vision and Values must be read and signed.
• OSHA Requirements and training to include: *Safety Training