Credit Processing Specialist

🔥 1 minute ago

🌴 South Carolina – Remote

🌴 South Carolina – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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Prisma Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Prisma Health is a comprehensive health care provider offering a wide range of medical services to ensure individuals achieve their healthiest state. With numerous locations, advanced technology, and expert specialists, Prisma Health provides accessible and convenient care. Services include primary care, specialized heart, cancer, women's, and children's health, as well as same-day and telehealth options. Prisma Health emphasizes community outreach and education to support overall health and wellness.

📋 Description

• Perform moderately to highly complex tasks relating to physician and hospital accounts • Analyze and interpret data throughout revenue-cycle functions • Analyze aged accounts and remittances to determine causes of denials, non-payment, and overpayment • Post, balance, and correct electronic remittances • Bill and follow up with government payers and specialized accounts • Analyze and correct coding-guideline issues • Prepare accounts for appeal • Review and analyze insurance and patient credit balances, including unapplied, unidentified, and undistributed balances • Analyze insurance and/or patient credit balances, determine root causes, and take corrective action • Contact payers and make hard inquiries about account status • Escalate problem accounts • Document billing activity and account indicators according to departmental guidelines • Ensure compliance with billing regulations, privacy requirements, HIPAA, and payer guidance • Participate in assignments and required training • Perform other duties as assigned

🎯 Requirements

• High School diploma or equivalent OR post-high school diploma / highest degree earned • Two (2) years of billing, bookkeeping, or accounting experience • Knowledge of job functions required for Denial/Appeals Specialist, Payment Research Specialist, and Quality Assurance Specialist roles • Knowledge of privacy, HIPAA, billing regulations, regulatory requirements, and payer guidance • Compliance with Prisma Health policies and procedures • Attendance at all required training