Credit Resolution Specialist
Company: Children's Hospital of the King's Daughters
Location: Chesapeake
Posted on: April 4, 2021
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Job Description:
General Summary: # The Credit Resolution Specialist is
responsible for monitoring and resolving accounts in a credit
status assigned in the work queue.# This role analyzes the account,
confirms current charges have been properly adjudicated, and
verifies that the payment by the payer and patient is accurate.
Reports to the Revenue Cycle Compliance Manager. # # Duties and
Responsibilities: Maintains compliance related to government payers
by analyzing the account and taking the required action to resolve
the credit# Analyzes account to determine the credit reason.
Utilizes payer remits, payer websites, the billing system and other
resources to determine the reason and action required. Ensures, if
two payers are involved, the correct primary/secondary payment is
on file for each payer. Updates insurance information based on new
information obtained, and request claim submission for new payer.
Enters and applies adjustments up to $1,000. Submits request for
adjustments greater than $1,000 for approval and processing. Enters
refunds to patient/parent/guarantor or payer up to $3,000.# Submits
request for refunds greater than $3,000 for approval and
processing. Audits specified accounts in a credit status. Performs
other duties as assigned.### Minimum Education and Experience
Requirements:# High school diploma or equivalent required. Minimum
of one-year credit resolution, customer service, and document
imaging acquired in a hospital patient account department,
physician office, or medical services organization.# Experience
with credit resolution functions from investigation, review, and
determination.# Must have experience with third-party payer
insurance processes from verification, billing, coding, and medical
terminology.# Ability to effectively gather and exchange
information in both oral and written communication with proper
grammar, spelling, and punctuation. Experience in working in a high
volume environment with specific deadlines to accomplish the task.
Strong computer skills with experience utilizing MS Office suite
required. #
Keywords: Children's Hospital of the King's Daughters, Chesapeake , Credit Resolution Specialist, Other , Chesapeake, Virginia
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