Credit Balance Specialist II

Amerita

Amerita is a leading provider of Specialty Infusion services focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. As one of the most respected Specialty Infusion providers in America, we service thousands of patients nationwide through our growing network of branches and healthcare professionals. The Credit Balance Categorization Specialist (CBS-II) will be responsible for facilitating the resolution of insurance and patient credit balances. The Credit Balance Categorization Specialist (CBS-II) will also work closely with other staff to identify, resolve, and share information regarding payer trends and provider updates.

REMOTE - must reside within the Continental USA.

HOURS -Mon - Fri 7:00a - 3:30pm MST

* Medical, Dental & Vision Benefits plus, HSA & FSA Savings Accounts
* Supplemental Coverage - Accident, Critical Illness and Hospital Indemnity Insurance
* 401(k) Retirement Plan with Employer Match
* Company paid Life and AD&D Insurance, Short-Term and Long-Term Disability
* Employee Discounts
* Tuition Reimbursement
* Paid Time Off & Holidays

* Ensures daily goals for cash collections, credit balances, medical records, correspondence, appeals/disputes, accounts receivable, and other departmental goals as outlined
* Adheres to all applicable state and federal regulations and company policies
* Maintains insurance contracts in terms of medical policies, payments, patient financial responsibility, credit balances, and refunds
* Verifies professional billed services for dispensed medication and supplies
* Validates reimbursements and appropriate deductible and cost share amounts to the patient
* Reviews remittance advices, payments, adjustments, insurance contracts and fee schedules, insurance eligibility and verification, and assignment of benefits to determine the correct credit classification
* Coordinates offsets and cash research requests with the cash applications department
* Utilizes approved credit categorization criteria to ensure accurate documentation in CPR+
* Creates patient refund packets and validates receipt of previously submitted payer disputes
* Works within established departmental goals and performance metrics
* Identifies and communicates issues and trends to management

High School Diploma or GED; some college desired
• One year of experience in Revenue Cycle Management, Managed Care, Medicare, and Medicaid Reimbursement
• Knowledge of automated billing systems, metric measurements, basic accounting practices, ICD 9/10, CPT, HCPCS coding, and medical terminology; CPR+ and Waystar preferred
• Strong communication, time management, and customer service skills
• Familiarity with Microsoft Office