Posting Note: *Medical insurance collections experience required
This position performs Accounts Receivable and Credit Resolution duties in accordance with established federal and state regulations.
- Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
- Excellence in clinical care, service and communication
- Collaborative within our institution and with others who share our mission and goals
- Leadership that set the standard for pediatric health care today and innovations of the future
- Accountability to our patients, community and each other for providing the best in the most cost-effective way.
Performs account follow-up on outstanding credit balances and takes the necessary action for account resolution in accordance with established federal and state regulations. Audits and reviews both PRC and HRC accounts for possible transfers of patient overpayment`s to resolve any patient responsibility of outstanding balances.
- Reviews and analyzes all credit balances to ensure the credit balance is valid. Pulls EOBs to submit to insurance with the necessary documentation for return of overpayment. Audits accounts for validity of overpayment`s and adjustments.
- Verifies insurance payment is in alignment with payer contract by reviewing the fee schedules loaded into MPV.
- Provides detailed documentation on the collection system to explain the action taken. Documents comments into account regarding credit balance and resolution.
- Monitors and tracks refund check request spreadsheet to ensure receipt. Maintains master spreadsheet of all refunds both patient and insurance with check numbers and dates of checks mailed.
- Establishes and maintains effective communication with collectors, insurance companies and other internal departments to secure accurate and pertinent information to process refunds.
- Responsible for achieving and maintaining credit balance days at the established percentage goal.
- Uses good interpersonal skills to promote positive, effective interaction with colleagues and to promote quality service to ensure flow of information to appropriate staff and professionals.
- Performs miscellaneous job related duties as requested.