Credit Resolution Representative II (Hospital Billing Credits) - PFS (Remote)

Trinity Health•Farmington Hills, MI

1d•$19 - $29•Remote

About The Position

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.

Requirements

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.
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.
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.

Nice To Haves

CPA certification preferred.
Experience in a complex, multi-site environment preferred.
Completion of regulatory/mandatory certifications and skills validation competencies preferred.

Responsibilities

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.