Job Description: • Work assigned credit balance inventory queues daily for hospital and physician accounts, prioritizing accounts based on ageing, dollar amount, payer requirements, and regulatory timelines. • Research the root cause of credit balances, including duplicate payments, overpayments, coordination of benefits errors, retroactive adjustments, contractual discrepancies, and posting inaccuracies. • Determine the appropriate resolution method for each credit balance, including: Refunds to payers or patients, Reallocation of payments to open balances, Contractual or administrative adjustments, when applicable. • Prepare and submit refund requests with complete and accurate supporting documentation. • Review remittance advice (ERAs/EOBs) and account transaction history to validate overpayment sources and resolution accuracy. • Apply credits to the oldest dates of service first, unless otherwise required by payer or regulatory guidelines. • Maintain clear, detailed account notes documenting research performed, actions taken, and final resolution. • Monitor payer and regulatory timelines to ensure timely resolution and avoid compliance risk. • Escalate complex, high-dollar, or non-standard credit balance scenarios in accordance with established workflows. • Partners with payment posting, insurance follow-up, billing, coding, and refund teams to resolve credit balances requiring cross-functional action. • Identify and report recurring credit balance drivers, payer trends, or system issues to leadership. • Support audit requests and quality reviews by providing account documentation and resolution details. • Participate in process improvement initiatives to reduce future credit balance volume. • Meet or exceed established productivity standards for credit balance accounts resolved. • Maintain high accuracy and compliance with payer contracts, refund policies, and regulatory requirements. • Ensure timely resolution of credit balances in accordance with organizational and payer timelines. • Adhere to documentation, audit, and compliance standards. Requirements: • High school diploma or equivalent required. • 3+ years of healthcare revenue cycle experience focused on credit balance resolution. • Strong attention to detail and ability to work effectively in a fast-paced environment. • Strong understanding of billing and collections processes. • Strong understanding of ERAs/EOBs, payer contracts, and overpayment resolution workflows. • Proficiency with patient accounting and practice management systems. • Ability to manage high-volume credit balance inventory independently. • Disciplined work ethic with ability to work remotely with little direct supervision and meet production targets. • Analytical and detail-oriented. • Strong prioritization and time management. • Clear written documentation. • Compliance-focused decision-making. • Collaborative problem-solving. Benefits: • Insurance/401k match • PTO/Paid holidays • Referral bonuses Apply tot his job