Credit Balance Specialist: Refunds & Reconciliations

Med-Metrix; Pasig; On-site; PHP 240,000 - 480,000; Full time

Job summary

Med-Metrix in the Philippines is seeking a Credit Management Representative responsible for all elements of credit balance management, including triaging patient and insurance credits, adjusting mispostings, and initiating refunds with proper documentation.

You will review daily work lists, research root causes of discrepancies, and collaborate with co-source partners and other teams. Knowledge of HIPAA and data confidentiality is essential.

Qualifications

• High school diploma or equivalent is required.
• 1 year of experience in insurance collections or credit balance management.
• 1-3 years in physician/professional billing.
• Understanding of ICD-10, CPT, HCPC codes.
• Ability to work independently and in a team.
• Proficiency with Microsoft Office.

Responsibilities

• Perform credit balance management for multiple clients.
• Review daily credit balance work list to initiate research of credit balance accounts.
• Research and resolve patient accounts including but not limited to posting errors, insurance overpayments, patient overpayments, and/or system issues.
• Prepare and submit refund requests with supporting documentation including EOBs and insurer correspondence.
• Correct misapplied contractual adjustments.
• Prepare spreadsheets for payers on special projects involving erroneous refunds.
• Review payer refund request letters and respond timely.
• Maintain work queues to ensure timely actions.
• Identify trends and escalate to supervisor.
• Adhere to client-specific workflows & tasks.
• Collaborate with co-source partners and other teams.

Skills

Strong communication skills

Teamwork

Microsoft Office proficiency

Education

High School diploma or equivalent

Tools

Microsoft Office

Job description

Med-Metrix in the Philippines is seeking a Credit Management Representative responsible for all elements of credit balance management, including triaging patient and insurance credits, adjusting mispostings, and initiating refunds with proper documentation.

You will review daily work lists, research root causes of discrepancies, and collaborate with co-source partners and other teams. Knowledge of HIPAA and data confidentiality is essential.