Job Description

Essential Duties and Responsibilities:

The Credit Applications Specialist is responsible to research and troubleshoot for various payers.  Verifying and processing refunds, post payments, and payment transfers.

  • Accurately and effectively research and resolve self-pay and insurance payment credits and offsets through transfer of payments and/or initiation of refunds.
  • Verify refunds are appropriately requested and complete Refund Request form.
  • Ensure all appropriate documentation to process refunds is included. Obtain any missing necessary documentation.
  • Perform manual posting of various commercial insurance and AHCCCS-- posting from EOBS and edits of electronic remits.
  • Perform manual posting of self pay and patient responsibility payments.
  • Accurately post payments and appropriately document in the system so that all staff can understand and can be used as legal doument if necessary.
  • Effectively communicate with other staff members and management.
  • Efficiently and effectively navigate IDX, Impower, Adobe Acrobat and payer portals.
  • Maintain client and patient confidentiality.
  • Manage special projects as assigned by supervisor.
  • Other tasks as assigned by Director of Operations, Associate Director of Billing, or other members of Management Team
  • Maintain compliance with all company policies and procedures.

Requirements:
Experience:

  • 3+ years medical collections experience preferred.
  • 2+ years medical payment posting experience preferred.
  • Prior experience with IDX, EPIC, Microsoft Access & Excel preferred.

Education:

  • High school diploma or equivalent.
  • Billing certification preferred.

 

Knowledge/Skills/Abilities:

 

  • Must have a strong understanding of insurance carrier payment and insurance EOBs plus ability to follow the payment through recoupments, offsets, etc.
  • Strong math skills as pertains determining correct payments and contractual adjustments.
  • Knowledge working with commercial insurance, Medicare, Medicaid, AHCCCS.
  • Health Insurance knowledge with regards to billling requirements, timely filing requirements and appeals process.
  • General understanding of accounting debits and credits.
  • Understanding/compliance of HIPAA laws and regulations.
  • Computer proficiency (MS Office – Word, Excel and Outlook)
  • Ability to manage multiple tasks and assignments.
  • Problem solving and analytical skills.
  • Excellent verbal and written communication skills.
  • Ability to read, understand and follow oral and written instructions.
  • Must be well organized, detail oriented and demonstrate exceptional accuracy.
  • Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices.
  • Able to work in a team environment.
  • Ability to work with minimal supervision
  • Ability to adapt to shifting priorities, seek supervision in prioritizing assigned tasks.
  • Ability to operate standard office machines and equipment, including telephones, computers, copy machines, fax machines, calculators, scanners.
  • Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.
  • Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards

Physical Requirements:

  •  Must be able to talk, listen, and speak clearly on telephone.
  • Requires sitting and standing associated with a normal office environment.
  • Manual dexterity needed for using a ten key calculator and computer keyboard.
  • Specific vision abilities include close vision, distance vision, depth perception and the ability to adjust focus.

Environmental Working Conditions:

  • Normal office environment.
  • The noise level of the work environment is usually moderate.
  • Occasional overtime maybe required and/or hours may be shortened as business needs dictate.

 

*The job holder must demonstrate current competencies applicable to the position.