Credit Balance Analyst

OrthoNebraska creates the inspired healthcare experience all people deserve by giving people a direct path to personalized care and life-enhancing outcomes. With a focus on safety and people, we set the bar high in providing high-quality care with an unmatched experience. Our team members are critical to our success and growth and are rewarded for their dedication and hard work. IF this sounds like the type of team and environment you want to be a part of apply today!

Position Summary: The Credit Balance Analyst, resolves credit balance issues, refunds, and overpayments for patients. They also ensure that patient accounts are adjusted and refunded accurately and on time.

Position details

Position Requirements

Education: High School Diploma or General Educational Development (GED) required.

Licensure: N/A

Certification: N/A

Experience: 2+ years of general office experience and billing experience required.

Required Knowledge/Skills/Abilities

• Knowledge of operation (user level) personal computer programs.
• Knowledge of medical terminology preferred.
• Must be able to demonstrate calm, rational thinking and clear communication when faced with deadlines and customer demands.
• Must be capable of responding to frequent priority changes and multiple deadlines.
• Team environment requires total participation by all members in problem solving and decision-making.
• Must be able to work with a multitude of individuals from varying professions and non-professional backgrounds.
• Able to communicate effectively to solve problems at the personal and unit level.
• Strong communication, including writing, speaking and active listening
• Great customer service skills, including interpersonal conversation, patience, and empathy
• Good problem-solving and critical thinking skills
• In-depth knowledge of industry best practices
• Must be able to multi-task with multiple interruptions in a fast-paced environment

Essential Job Functions

• The Credit Balance and Refund Specialist resolves credit balance accounts for patients by reviewing claims, payments, and denials while ensuring compliance with industry standard.

• Responsible for timely and accurate resolution of patient credit balance accounts and refund request.
• Reviews and analyzes accounts and/or reports for patients to facilitate the resolution of credit balance accounts.
• Utilizes available resources to review payment discrepancies and identify trends/reasons for future discussion.
• Conduct routine accuracy checks of selected data to ensure completeness and accuracy of data.
• Effectively utilize time to provide efficient customer service.
• Proactively identifies, researches and resolves unusual, complex or escalated issues, as necessary. Escalates ongoing issues or concerns with leadership.
• Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation.
• Meets quality assurance and productivity standards through identification, reconciliation of credit balance accounts in accordance with organizational policies and procedures.
• Completes due diligence on all refund requests to ensure that request is valid and accurate.
• Serves as a dedicated resource person to answer questions pertaining to patient credit balances.

• Actively participate in achieving team goals, setting priorities, seizing opportunities before being asked, and motivating oneself and others in order to maximize productivity

• Adapts quickly to frequent process changes and improvements.
• Maintain up-to-date knowledge of all business office policies and procedures, team goals, department objectives and hospital strategic plans to maximize the decision-making process.

• Demonstrate communication and problem-solving skills by clearly presenting information and options to customers while removing barriers that fail to enhance customer service
• Maintain confidentiality to protect patient rights and privacy.
• Comply with safety activities, policies and procedures and regulatory requirements such as OSHA and The Joint Commission
• Employee is responsible for all other duties as assigned for which competency has been demonstrated.

Physical requirements: This position is classified as Sedentary Work in the Dictionary of Occupational Titles, requiring the exertion of up to 10 pounds of force occasionally) up to (33% of the time) and/or a negligible amount of force frequently (33%-66% of the time) to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time.