Credit Management Representative - Pasig

Para lamang sa mga rehistradong miyembro Pasig, Pilipinas

1 buwan ang nakalipas

Buong oras

Job summary

The Credit Management Representative is responsible for all elements of Credit Balance Management which include but are not limited to: Triaging patient and insurance credit balance to determine root cause correcting contractual/manual adjustments identifying overpayments and creating refund requests including appropriate documentation to support refund identifying posting/payer trends and communicating to management for resolution.

Key Responsibilities Include:

Perform credit balance management for multiple clients
Review daily credit balance work list to imitate research of credit balance accounts
Research identify root cause resolve patient accounts including but not limited to posting errors insurance overpayments patient overpayments system issues prepare submit refund requests as appropriate obtaining all pertinent back-up data EOBs insurance company correspondence refund letter explanation explanation reimbursement practice management system correct misapplied contractual adjustments prepare spreadsheets payers special projects involving erroneous refunds payer retractions review payer refund request letters take action resolve respond timely maintain WQ's assigned ensure accounts worked timely manner identify escalate supervisor adhere unique client specific assigned workflows tasks collaborate effectively co-source partners functional teams supporting business retrieve post payments denials uses MCX workflow client host payer websites tools available perform special projects duties assigned assists utilizing excel spreadsheets ability communicate results meets maintains daily productivity standards departmental policies adheres policies procedures established client team maintain confidentiality maintain professional attitude other duties assigned management team use protect disclose patients protected health information PHI accordance Health Insurance Portability Accountability Act HIPAA standards understand comply Information Security HIPAA policies procedures times limit viewing PHI absolute minimum necessary perform assigned duties understand fundamental concepts healthcare reimbursement methodologies basic knowledge healthcare claims processing ICD-10 CPT HCPC codes work well individually team environment proficiency Microsoft Office strong communication skills written strong organizational skills interpersonal skills ability communicate levels organization strong problem solving creative judgment make decisions accurate analyses high level integrity dependability sense urgency results oriented excellent written verbal communication required gracious welcoming personality customer service interaction

Paglalarawan ng trabaho

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