Capitalhealth · 3131 Princeton PikePrepare for this interview
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Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region. Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates. The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time). Pay Range: $20.91 - $27.19 Scheduled Weekly Hours: 40 Position Overview Performs all hospital and professional billing credit balance resolution tasks for insurance and other third-party payors to full completion as assigned by the Credit Balance Resolution Coordinator. Research credit balances, provides supporting evidence, communicates findings and performs billing system adjustment or other necessary actions to resolve credit balances. Prepares, submits, and ensures completion of refunds and retractions where appropriate to resolve credit balances MINIMUM REQUIREMENTS Education: High school diploma or equivalent. Experience: One year experience in accounting, finance, or healthcare Revenue Cycle billing operations. Other Credentials: Knowledge and Skills: Possesses knowledge of Revenue Cycle billing functions, such as pre-bill edits, claim submission, accounts receivable or payment posting. Special Training: Experience working in excel. Experience as an end user in Epic, Athena, or Cerner preferred Mental, Behavioral and Emotional Abilities: Ability to take direction, work independently, and meet assigned deadlines. Research. Usual Work Day: 8 Hours Reporting Relationships Does this position formally supervise employees? No If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager. ESSENTIAL FUNCTIONS Performs assigned tasks for all government, commercial, and special, contracted and non-contracted insurers, including other third-party payors to resolve credit balances Takes direction and supports the Credit Balance Resolution Coordinator with communication and collaboration with billing and cash applications staff if needed Research credit balances and provide supporting evidence, communicates findings and performs billing system adjustments or other necessary actions to resolve credit balances. Prepares, submits, and ensures completion of refunds and retractions where appropriate to resolve credit balances. Performs billing tasks to resolve credit balances as assigned. Reviews host billing systems, cash posting reports, EOBs, claims status documentation, payer portals, and communicates with insurance company customer service representatives for accurate research to determine the cause of credit balances. Tracks and trends historical and current credit balance data to help identify potential future credit balance risks. Routinely reviews credit balances to identify payment calculation variances with contracts, fee schedule, and claims where appropriate. Reviews pre and post applied adjustments to the billing systems in accordance with daily, weekly, and monthly expectations for root cause analysis, corrections, and prevention. Supports larger credit balance projects with payer documentation preparation and meeting participation (where needed). Performs other duties as assigned. PHYSICAL DEMANDS AND WORK ENVIRONMENT Frequent physical demands include: Pinching/fine motor activities , Keyboard use/repetitive motion , Talk or Hear Occasional physical demands include: Standing , Walking , Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Wrist position deviation Continuous physical demands include: Sitting Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs. Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Color Discrimination, Minimal Depth Perception, Minimal Hearing Anticipated Occupational Exposure Risks Include the following: N/A This position is eligible for the following benefits: Medical Plan Prescription drug coverage & In-House Employee Pharmacy Dental Plan Vision Plan Flexible Spending Account (FSA) - Healthcare FSA - Dependent Care FSA Retirement Savings and Investment Plan Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance Supplement
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