Credit Resolution Representative II – Hospital Claims

🔥 0 minutes ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $17 - $26 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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Trinity Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

📚 Education

🤝 Non-profit

Healthcare • Education • Non-profit

Trinity Health is a Christian K-12 educational institution located in Wichita, Kansas, dedicated to providing a Christ-centered education that nurtures spiritual growth and academic excellence. The academy emphasizes the importance of faith in students' lives, integrating spiritual development with rigorous academic programs and a broad array of extracurricular activities, including athletics and fine arts. Trinity Health fosters a supportive community where teachers and families collaborate to help students develop a personal relationship with Jesus Christ and excel in their studies.

📋 Description

• Process credit account balances from patients and insurers within Hospital and/or Medical Group revenue operations • Reduce patient balance accounts receivable credits and coordinate with customer service teams regarding patient overpayments • Determine root causes of credit balances and take appropriate steps to fully adjudicate accounts • Post patient balance refunds and rebill claims as needed • Ensure accurate submission of claims and patient statements • Perform daily Payment Posting team activities, including reviewing, monitoring, and following up on patient credit accounts receivable • Document corrections, discrepancies, outstanding items, exceptions, rejections, and follow-up activities in appropriate systems • Track payment activity and findings for the Supervisor • Perform account adjustments or write-offs in accordance with policy • Research credit balances caused by payment posting and prepare documentation • Serve as backup to Payment Posting Representatives • Prepare refund checks to patients and enter data into appropriate systems • Promote accurate cash posting and reconciliation • Ensure timely, tracked, trended, and reported cash-posting processes • Maintain compliance with applicable laws, regulations, Trinity Health's Integrity and Compliance Program, Code of Conduct, policies, and procedures • Report directly to the Supervisor Payment Posting

🎯 Requirements

• High school diploma or Associate's degree in Accounting or Business Administration with at least two (2) years of experience and relevant knowledge of revenue cycle functions and systems within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting, or customer service activities, or an equivalent combination of education and experience • Experience in medical claims credit resolution working with all commercial and government payors • Knowledge of revenue cycle functions and systems • Some knowledge of health insurance and governmental programs, regulations, and billing processes, including Medicare, Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, managed care contracts and coordination of benefits highly desired • Experience in a complex, multi-site environment preferred • Experience working with the Epic medical system highly desirable • Proficient in Microsoft Office, including Outlook, Word, PowerPoint, and Excel • Excellent written and verbal communication skills and organizational abilities • Strong interpersonal skills in interacting with internal and external customers • Strong accuracy, attention to detail and time management skills • Completion of regulatory/mandatory certifications and skills validation competencies preferred • Must be comfortable operating in a collaborative, shared leadership environment • Must possess a personal presence characterized by honesty, integrity, and caring, with the ability to inspire and motivate others to promote Trinity Health's philosophy, mission, vision, goals, and values • Ability to operate a keyboard and communicate extensively by telephone and in person • Ability to concentrate, meet deadlines, manage several projects concurrently, adapt to interruptions, organize work priorities, and comply with Trinity Health policies and procedures