Credit Resolution Representative - Remote

Tenet Healthcare Corporation

7h • $17 - $26 • Remote

About The Position

Responsible for performing the refunds and credit analyses functions within the Hospital Revenue Cycle Management team.

Requirements

• Entry level understanding of hospital billing form requirements (UB04 and HCFA 1500)
• Entry level knowledge of ACE/PBAR/STAR/Meditech or EPIC preferred
• Entry level knowledge of ICD-10, HCPCS/CPT coding and medical terminology
• Entry level writing skills
• Contract Interpretation skills greatly preferred
• Understanding and interpretation of Managed Care contracts
• Understanding of Gov’t Medicare and multiple state Medicaid programs payor regulations (if Gov’t team)
• High School Diploma or equivalent experience, preferred.
• 1 – 3 years’ experience in a hospital business environment performing billing and/or follow-up functions, preferred.

Responsibilities

• Performs refund and credit analyses, audit and reimbursement functions for all Managed Care, Commercial, Medicare, Medicaid, Self-pay and third party payors for all patient accounts. Determines if credit balance is an over contractual, late charges applied, overpayment etc. to ensure appropriate actions are taken to resolve.
• Performs Quarterly reviews for Medicare and Medicaid (based on state guidelines) and submits to client for approval, signature and submission.
• Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory Accurately and thoroughly documents the pertinent credit balance review activity performed.
• Communicate issues to management, including payer, system or escalated account issues.
• Handle correspondence received from payers and patients requesting refunds. Respond timely to emails and telephone messages as appropriate
• Participate and attend meetings, training seminars and in-services to develop job knowledge.
• Other duties as assigned by Management.

Benefits

• Medical, dental, vision, disability, and life insurance
• Paid time off (vacation & sick leave) – min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked.
• 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED