Role Overview
This position focuses on identifying and resolving credit balances in patient accounts, ensuring billing accuracy and alignment with client guidelines and regulatory requirements. The ideal candidate is detail-oriented, analytically strong, and experienced in healthcare financial operations.
Key Responsibilities
- Examine patient accounts with credit balances to determine root causes
- Enter and maintain accurate patient account data
- Investigate credit balances using client-provided documentation and apply appropriate resolutions
- Process refunds and contractual adjustments to correct account balances
- Identify patterns in credit balance occurrences and report trends
- Participate in regular accounts receivable review meetings
- Escalate complex or unresolved cases following defined protocols
- Ensure timely submission and correction of institutional and professional claims
- Communicate with third-party payors to verify claim status for both hospital and physician services
- Review refund-related documentation for completeness and accuracy before processing
Required Qualifications
- Minimum of three years’ experience in credit balance analysis or project-based work within professional or consulting services
- Proven ability to work independently, particularly in remote environments
- Strong command of Microsoft Word, Excel, PowerPoint, Outlook, and web-based platforms
- Ability to interpret 835 EDI remittance advice and apply it to account reconciliation
- Familiarity with financial and accounting terminology
- Effective project coordination, time management, and organizational abilities
- Focus on process efficiency and quality, with the capacity to manage multiple tasks under deadlines
- Strong analytical thinking to detect trends and contribute to process improvements
- Bachelor’s degree in Business, Finance, or a related discipline
Preferred Qualifications
- Prior experience working in a remote or distributed team setting
Technical Environment
Proficiency in Microsoft Office applications, web-based tools, and 835 EDI data interpretation is essential for success in this role.
Work Environment
This is a hybrid position with work locations in Indianapolis, Nashville, and Denver. Candidates must be able to support both remote and in-office requirements as needed.
