• Credit Balance Representative

    Job ID
    2018-23897
    Employment Type
    full-time
    Hours Per Week
    40
    Onsite Work Schedule Details
    8AM - 5PM
    Address
    5543 Legacy Drive
    City
    Plano
    State
    TX
  • Overview

    The Credit Balance Representative is responsible for reviewing related data to determine if contractuals, adjustments, or a refund is required to correct account balance. This position conducts research of explanation of benefits, contracts, and multiple client systems. 

    Responsibilities

    • Reviews credit balances to assess whether a refund is applicable based on the accuracy of billing, insurance payments, contractuals and adjustments. Completes all appropriate documentation to support each refund for approval according to departmental policy.
    • Determines reason for outstanding credits and recommends resolutions.
    • Meets productivity standards and achieves benchmarks as they pertain to job responsibilities.
    • Reviews each payer and the contract guidelines for refund timelines.
    • Appeals any correspondence requests for refunds that are inappropriate.
    • Documents all accounts with detailed notes of action taken to resolve credit balance.
    • Verifies accuracy of adjustments posted to the account prior to initiating a refund, including UCR guidelines.
    • Reviews electronic and manual payer EOBs to determine contractual, denials, adjustments, and patient responsibility.
    • Prints all backup documentation associated with refund.
    • Makes copies of all pertinent information for the refund to be mailed with the refund check.
    • Mails all refund checks timely.
    • Logs refund batches on daily refund spreadsheet accurately.
    • Completes payment transfers and corrects adjustments.
    • Supports nThrive’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable to nThrive’s business practices. This includes: becoming familiar with nThrive’s Code of Ethics, attending training as required, notifying management or nThrive’s Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations.

    Qualifications

    • High School diploma or GED.
    • 2+ years of experience processing medical insurance and patient refunds in a hospital facility.
    • Demonstrated ability to meet performance objectives.
    • Demonstrated ability to navigate Internet Explorer and Microsoft Office.
    • Experience using a 10-key calculator for basic accounting. 
    • Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions and decimals.
    • Ability to calculate figures and amounts such as discounts and percentages.

    About nThrive

    Be Inspired. Ignite Change. Transform Health Care.
    From Patient-to-Payment, nThrive provides all the technology, advisory expertise, services, analytics and education programs health care organizations need to thrive in the communities they serve. Our colleagues share a united passion to help health care organizations strengthen their financial position, which translates to accessible, quality care for all. This passion fuels our drive to innovate and participate in community outreach through the nThrive CARES program. Our colleagues are encouraged to think differently and empowered to make a lasting impact that ensures our health care providers, and our world, are healthy and productive.

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