Position Summary:
The Credit Balance Analyst is responsible for processing refunds for third party insurance, Medicare, Medicaid, and Government-Assisted Programs; for both hospital and professional billing. Candidate will be expected to comply with all regulatory bodies and agencies. This will be accomplished by reviewing credit balances on accounts, to resolve by correction, refund or inquiry, and ensures compliance with internal and external customers via verbal and written communication. Candidate will also be responsible for incoming refund request letters from the insurance company. Candidate will be responsible to research and validate refund request. Candidate must have excellent customer service skills to communicate with internal and external customers. Candidate will be expected to use electronic billing. Candidate must demonstrate critical thinking skills to manage day to day basic operations or the ability to seek assistance when needed. Candidate must be able to do work steadily, efficiently and show constant vigilance to the details of the work. Candidate must be able to utilize all office equipment including personal computer and application software, printer, fax, copier, and multi-line phone system. Candidate must have good working knowledge of all insurance and/or Government rules regarding payment, credit procedures, claims submittal and appeal process. Candidate must have excellent written and oral communication skills, including English usage, grammar, punctuation, and style. Candidate must be able to use appropriate reference materials when needed. Candidate should be able to multi-task when needed.
Minimum Qualifications:
Required
- High school diploma or equivalent.
- One (1) year of general or medical office experience.
Preferred
- Associate’s degree in a related field.
- Three (3) years of medical billing experience in a hospital setting.
- Intermediate knowledge of Medicare billing.
Essential Job Functions:
In addition to the essential functions of the job listed below, employees must have on-time completion of all required education as assigned per DNV requirements, Bozeman Health policy, and other registry requirements.
- Review credit balances on accounts and refund requests from insurance
- Resolve credit balances/refunds by correction or adjustment
- Issue inquiries to insurance
- Issue refunds to insurance
- Other duties as assigned
Knowledge, Skills, and Abilities
- Demonstrates sound judgement, patience, and maintains a professional demeanor at all times
- Ability to work in a busy and stressful environment
- Strong interpersonal, verbal and written communication skills
- Exercises tact, discretion, sensitivity and maintains confidentiality
- Self-directed, completes assignments accurately, thoroughly and with minimal oversight
- Computer applications, MS Office, EMR, internet applications and standard office equipment
- Detail oriented, organizational skills and the ability to prioritize
Schedule Requirements
- This role requires regular and sustained attendance.
- The position may necessitate working beyond a standard 40-hour workweek, including weekends and after-hours shifts.
- On-call work may be required to respond promptly to organizational, patient, or employee needs.
Physical Requirements
- Lifting (Rarely – 30 pounds): Exerting force occasionally and/or using a negligible amount of force to lift, carry, push, pull, or otherwise move objects or people.
- Sit (Continuously): Maintaining a sitting posture for extended periods may include adjusting body position to prevent discomfort or strain.
- Stand (Occasionally): Maintaining a standing posture for extended periods may include adjusting body position to prevent discomfort or strain.
- Walk (Occasionally): Walking and moving around within the work area requires good balance and coordination.
- Climb (Rarely): Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like using feet and legs; may also use hands and arms.
- Twist/Bend/Stoop/Kneel (Occasionally): Twisting, bending, stooping, and kneeling require flexibility and a wide range of motion in the spine and joints.
- Reach Above Shoulder Level (Occasionally): Lifting, carrying, pushing, or pulling objects as necessary above the shoulder, requiring strength and stability.
- Push/Pull (Occasionally): Using the upper extremities to press or exert force against something with steady force to thrust forward, downward, or outward.
- Fine-Finger Movements (Continuously): Picking, pinching, typing, or otherwise working primarily with fingers rather than using the whole hand as in handling.
- Vision (Continuously): Close visual acuity to prepare and analyze data and figures and to read computer screens, printed materials, and handwritten materials.
- Cognitive Skills (Continuously): Learn new tasks, remember processes, maintain focus, complete tasks independently, and make timely decisions in the context of a workflow.
- Exposures (Rarely): Bloodborne pathogens, such as blood, bodily fluids, or tissues. Radiation in settings where medical imaging procedures are performed. Various chemicals and medications are used in healthcare settings. Job tasks may involve handling cleaning products, disinfectants, and other substances. Infectious diseases due to contact with patients in areas that may have contagious illnesses.
- Frequency Key: Continuously (100% - 67% of the time), Repeatedly (66% - 33% of the time), Occasionally (32% - 4% of the time), Rarely (3% - 1% of the time), Never (0%).
The above statements are intended to describe the general nature and level of work being performed by people assigned to the job classification. They are not to be construed as a contract of any type nor an exhaustive list of all job duties performed by individuals so classified.