Credit Resolution Representative-II (PB)- PFS (Remote)

Trinity Health Mid-Atlantic; Farmington Hills (MI); Remote; USD 27,000 - 40,000; Full time

Job summary

Trinity Health is seeking a remote Credit Balance Specialist to process and resolve patient and insurer credit balances. The role supports the Patient Business Services (PBS) revenue operations, posting payments/rejections and rebilling as needed to keep credit accounts current.

The position requires strong attention to detail, MS Office proficiency, and effective communication skills in a hospital setting.

Qualifications

• Education aligned with accounting or business administration.
• CPA certification preferred.
• Experience in a hospital or healthcare revenue cycle environment is desirable.

Responsibilities

• Review and follow up on insurance, patient, and Medicare credits in AR.
• Investigate discrepancies and document corrections in system records.
• Assist with posting payments and credits to ensure accurate cash posting.
• Communicate with customers and internal teams to resolve overpayments.

Education

High school diploma or Associate's degree in Accounting or Business Administration or related field

CPA certification preferred

Tools

Microsoft Office (Outlook, Word, PowerPoint, Excel)

Job description

Employment Type

Full Time

Shift

Day Shift

Position Purpose

Work Remote Position (Pay Range: $19.5965--$29.3948) Performs day-to-day activities required to process credit account balances from patients and insurances within the Hospital and/or Medical Group revenue operations ($3-5B NPR) of a Patient Business Services (PBS) location. Serves as a member of a team at an assigned PBS location responsible for reducing account receivable credits, communicating with insurance companies, and coordinating with the customer service team to communicate to patients regarding overpayments. Responsibilities require expertise in determining the root cause of credit balances and in taking the appropriate steps to resolve issues resulting in full adjudication of an account. Work activities include posting payments and rejections from insurance companies and rebilling claims as needed to maintain manageable credit accounts receivable and to ensure accurate submission of claims and patient statements. This position reports directly to the Supervisor Payment Posting.

Essential Functions

• Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions
• Performs daily activities of the Payment Posting team which reviews, monitors and performs follow up on insurance, patient, and Medicare credit accounts receivable as part of the revenue cycle process for an assigned PBS location
• Documents corrections regarding discrepancies created, and outstanding items and exceptions in appropriate systems regarding rejections and follow up activities performed in order to enable others to review claim history on all accounts.
• Tracks data on payment activity and findings for the Supervisor.
• Performs account adjustments or write-offs as needed in accordance with the Write-off-Policy.
• Researches credit balances caused by payment posting and prepares appropriate documentation.
• Provides feedback to the Cash Posting team based on credits worked.
• Serves as a back up to the Payment Posting Representatives.
• Prepares refund checks to patients and insurances and enters data into appropriate system.
• Performs duties in a manner which promotes accurate cash posting and reconciliation.
• Adheres to proactive practices, including cash posting of all incoming payments in a timely and effective manner.
• Performs processes related cash posting to ensure such activities are submitted timely, tracked, trended and reported to key stakeholders.
• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Integrity and Compliance Program and Code of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

Minimum Qualifications

• High school diploma or Associate's degree in Accounting or Business Administration or related field, with up to three (3) or more years of relevant knowledge of revenue cycle functions and systems and experience 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.
• CPA certification preferred.
• Experience in a complex, multi-site environment preferred.
• 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 that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.

Physical and Mental Requirements and Working Conditions

This position operates in a typical office environment. The area is well lit, temperature controlled and free from hazards. Incumbent communicates frequently, in person and over the phone, with people in all locations on product support issues. Manual dexterity is needed in order to operate a keyboard. Hearing is needed for extensive telephone and in person communication. The environment in which the incumbent will work requires the ability to concentrate, meet deadlines, work on several projects at the same time and adapt to interruptions. Must be able to set and organize own work priorities and adapt to them as they change frequently. Must be able to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles. Must possess the ability to comply with Trinity Health policies and procedures. The above statements are intended to describe the general nature and level of work being performed by persons assigned to this classification. They are not to be construed as an exhaustive list of duties so assign

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care.

Equal Opportunity Employer Statement

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Trinity Health Background

Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. Together, we’re 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, our system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations, and many other health and well-being services. Based in Livonia, Michigan, in fiscal year 2023, we invested $1.5 billion in our communities through charity care and other community benefit programs.

Contact Information

For more information, visit http://www.trinity-health.org. You can also follow Trinity Health on LinkedIn.