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Company Name : Allegheny Health Network
Location : Pennsylvania
Position : Credit Balance Specialist – REMOTE
Job Description : Company :
Allegheny Health Network
Job Description :
GENERAL OVERVIEW:
Responsibilities of the Credit Balance Specialist include the compliant review and comprehensive analysis of credit balance accounts to determine cause and resolution of the credit, either through contract allowances or refunds/reimbursement to insurance companies. In addition, the representative is responsible for thorough and accurate follow-up and communication with management to assist in developing root cause analysis of the credit balances.
ESSENTIAL RESPONSIBILITIES:
Reviews daily credit balance work lists to initiate research of credit balance accounts (20%)
Complete all form refund requests in compliance with contract terms (20%)
Efficiently responds to correspondence received from payers requesting refunds (20%)
Reports on root causes of credits to management (20%)
Is responsible for follow up on credit balance accounts (20%)
Performs other duties as assigned or required
QUALIFICATIONS:
Minimum
High school diploma/GED
1-3 years in healthcare related billing role
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )
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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
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