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University of Florida Jacksonville Physicians, Inc. · 1 month ago

Credit Balance Analyst | Refunds Department | Days | Full-Time

Jacksonville, FL

Full-time

Onsite

Entry Level

2+ years exp

University of Florida Jacksonville Physicians, Inc. is seeking a Credit Balance Analyst to review and analyze self-pay and insurance account credit balances. The role involves ensuring accurate resolution of credit balances through various processes, responding to inquiries, and maintaining compliance with regulatory guidelines.

Hospital & Health Care

Responsibilities

The Credit Balance Analyst must understand State and Federal Payor Guidelines

Track refund completion by ensuring all stages of the refund process is followed

Provide explanations for account status(es) for incoming inquiries received via; Electronic correspondence (Epic Correspondence Module), Fax transmittals, email and/or phone calls

Provide timely responses to refund requests from Internal and/or External business partners, such as insurance companies, Revenue Cycle Teams, Patient Service Representatives, Collections, Clinics etc

When applicable, contact patients and/or insurance companies to verify "Pay to" information and validate mailing addresses

Performs all other duties that may be assigned in the best interests of the team and the company

Apply knowledge of provider billing and practices to the research accounts with credit balances

Research and identify, the cause of credit balance(s) for various team functions such as: Curae Workqueue, Pre-Admit Workqueue, OMFS Workqueue, OB Workqueue, Hospital Credit Balance review, Unclaimed Property Returned Item Research etc

Conduct timely review of outstanding balances, apply overpayment(s) and/or initiate the refund

Analyze payments based on regulatory guidelines, ensuring administrative charges, coding and billing align to EOB (Explanation of Benefits) details, which includes, determining whether the payments were paid and posted correctly

Take ownership of assigned workloads, to meet and/or exceed departmental metrics and standards, while supporting the reduction of A/R balances

Engage Revenue Cycle Department as needed, to aid in accurate allocation of charges

Responsible for review, correction, and resolution of all account credit balances

Confirm accuracy of refund check detail to include demographic information and dollar amount as captured in the Accounts Payable system