Full-Time Insurance Credit Resolution Specialist

• Reviewing and responding to correspondence from physician practices.
• Answering incoming inquiries.
• Preparing insurance refund checks for mailing, and processing returned checks.
• Identify and review patient accounts with insurance overpayments.
• Reconcile account balances by applying, transferring, or refunding credits.
• Analyze explanation of benefits (EOBs) and insurance payments.
• Process refunds for insurance companies.
• Prepare and submit refund requests according to established policies and procedures.
• Ensure proper documentation and communication regarding refund transactions.
• Resolve outstanding credits or account discrepancies.
• Ensure all refund and credit transactions are conducted in compliance with healthcare regulations, including HIPAA.
• Maintain detailed records of all credit and refund activities for auditing and reporting purposes.
• Respond to inquiries regarding refunds, and resolve issues.
• Use Salesforce to manage worklists and requests/inquiries from Care Centers

• High School Graduate, Medical Office training certificate or relevant experience
• Familiar with Arizona Medicaid (AHCCCS) and Arizona Medicare.
• 3+ years experience in physician revenue cycle / claims management
• Background with posting charges, claim follow up, collections, and payment posting
• Experience working with athenahealth’s suite of tools
• Comply with HIPAA rules and regulations
• Experience with AZ Payers preferred.

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