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Credit Balance/Audit Specialist

Company Name:
MCG Health System
Credit Balance/Audit Specialist
Req Number: 10456
Department Name: 5200 Patient Accounts
Shift: Days/No Weekends
Position Status: Full Time
Employment Status: Regular
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Position Description
Under the supervision of the Denials Manager, the Credit Balance/Audit Specialist is responsible for performing accounts receivable analysis and resolution of credit balance patient accounts, including refund requests and contractual allowance corrections. The Credit Balance/Audit Specialist is responsible for ensuring third party and patient claims with credit balances are resolved accurately and timely and that all required reporting and documentation is filed to meet payer requirements. Also responsible for performing financial audits on patient accounts as requested from both internal and external parties. Provides support and assistance to the Billing Manager as directed. The Credit Balance Specialist should remain in full compliance with all departmental, institutional and regulatory policies and procedures at all times. The roles and responsibilities of this job support the mission, vision, values and strategies of GRHS.
Position Requirements
High School graduate or GED required. Minimum of 1-2 years patient accounting experience in a healthcare environment. Excellent phone etiquette and internal/external customer service skills required. This competence is further demonstrated by knowledge of insurance regulations, adjudication guidelines and policies, and the ability to communicate and work with payers to get accounts resolved and paid accurately. Demonstrate in-depth knowledge and experience in the following technology solutions: patient accounting, optical imaging, scanning, patient systems, data quality monitoring and internet-based insurance websites.
Preferred Requirements
Medical terminology, knowledge of insurance and reimbursement procedures preferred. Business courses such as medical terminology, accounting, finance, cash applications, typing, word processing and knowledge of insurance companies preferred. Experience with Microsoft Word and Excel preferred. Extensive knowledge of Medicare and Medicaid regulations and other insurance guidelines preferred. Certification is not required.
We are an Equal Opportunity Employer and do not discriminate against applicants due to race, ethnicity, gender, veteran status, or on the basis of disability or any other federal, state or local protected class.

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