Credit Balance Specialist (Remote US)

Job Description

TREND Health Partners is tech-enabled payment integrity company. Our mission is to facilitate collaboration between payers and providers for mutual benefit and waste reduction, ultimately improving access to healthcare. We achieve this by aligning the common goals of payers and providers and fostering collaboration through a shared technology platform and seamless workflows.

Joining TREND Health Partners means becoming part of a dynamic, growing organization that promotes a collaborative and innovative work environment.

The Credit Balance Specialist’s primary responsibility is to conduct thorough screening of all in-scope credit balance accounts at the provider site. The role ensures timely review of credits in alignment with provider expectations, particularly based on account aging, dollars or provider expectations. This role is accountable for identifying and resolving straightforward credit issues quickly, flagging any impediments, and escalating complex cases or potential refunds for further evaluation. Additional responsibilities can include preparing documentation for provider approval and follow-up attempts for resolution. This position plays a critical role in maintaining operational efficiency and accuracy in credit balance management.

Role and Responsibilities

• Confirm account details and financial transactions in assigned Provider patient accounting system and other supporting applications
• Review and reverse invalid adjustments to clear credit balances
• Accurately provide detailed resolutions and/or impediments to resolve assigned credit balances
• Review/Respond to system (TRENDAnalyze) rejections in a timely manner (max 48 hours)
• Review/Respond to QA Rejections in a timely manner (max 48 hours)
• Manage accounts receivable to obtain closure on identified Client overpayments in a timely manner, and capture follow-up notes on the Provider Submission, as applicable.
• Prepare required documentation for provider approval on identified overpayments, as applicable
• Escalate to leadership any situation outside the employee's control that could adversely impact the business relationship

Qualifications

• High School Diploma
• Knowledge of administrative procedures and systems such as word processing, managing files and records, and workplace terminology
• Skilled in understanding the implications of new information for both current and future problem-solving and decision-making
• Ability to concentrate on a task over a period of time without being distracted
• Skilled in giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times
• Ability to apply general rules to specific problems to produce answers that make sense
• Ability to listen to and understand information and ideas presented through spoken words and sentences
• Ability to read and understand information and ideas presented in writing

Preferred Skills

• Knowledge and experience in Revenue Cycle or Patient Accounting
• Technical proficiency with Microsoft Excel

Mental and Physical Demands

• This position will be exposed mainly to an indoor office environment and will be expected to work in or around computers and printers.
• The nature of the work is sedentary, and the employee will be sitting most of the time.
• Essential physical functions of the job include typing and the repetitive motion to utilize computer software and hardware continuously throughout the day.
• Essential mental functions of this position include concentrating on analytical tasks, reading information, and verbal/written communication to others continuously throughout the day.

Related Duties As Assigned

• This job description documents the general nature and level of work but is not intended to be a comprehensive list of activities, duties, or responsibilities required for this position. Consequently, employees may be asked to perform other duties as required.
• Employees may also be asked to complete certain compliance requirements set forth by our Business Partners in the performance of their jobs including but not limited to requests for background and drug screenings and disclosures of personal health information or personally identifiable information. Exemptions as provided under the ADA and TITLE VII of the Civil Rights Act will be observed and followed.