[Hiring] Credit Resolution Escalation Specialist @Ventra Health

Role Description

The Credit Resolution Escalation Specialist is responsible for the monitoring and resolving credit balances and refunds from billing system’s overages. Daily assignments are provided by the supervisor and the Credit Resolution Escalation Specialist must develop a plan to complete work lists by the end of each day. The Credit Resolution Escalation Specialist must comply with applicable laws regarding billing standards and be able to operate in a team-oriented environment that strives to provide superior service to our providers throughout the country.

• Processes, researches, and resolves credit balances and refunds from a billing system’s overages that are escalated from the Credit team.
• Reviews refund request letters and determines an appropriate resolution based on contract and timely guidelines.
• Identifies trends and notifies appropriate departments.
• Ensures that all check registers are sent to Client Success or finance for approval.
• Ensures we receive all check numbers from Client to be uploaded into the system to ensure credits can be cleared.
• Ensures all returned refund checks are researched and corrected.
• Analyzes data from various reports and makes recommendations accordingly.
• Performs special projects and other duties as assigned.

Qualifications

• High School Diploma or Equivalent.
• Two (3) years of experience posting insurance payments in a healthcare setting.
• Two (3) years of experience reading insurance Explanation of Benefits (EOB) statements preferred.

Requirements

• Knowledge of Explanation of Benefits (EOB) statements.
• Knowledge of a variety of insurance plans.
• Strong oral, written, and interpersonal communication skills.
• Strong word processing, spreadsheet, and database software skills.
• Strong mathematical skills in addition, subtraction, multiplication and division of whole numbers and fractions; computing percentages; and working with decimals.
• Strong time management skills.
• Strong organizational skills.
• Ability to read, understand, and apply state/federal laws, regulations, and policies.
• Ability to take initiative and effectively troubleshoot while focusing on innovative solutions.
• Ability to remain flexible and work within a collaborative and fast-paced environment.
• Ability to communicate with diverse personalities in a tactful, mature, and professional manner.

Benefits

• Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons.
• This position is also eligible for a discretionary incentive bonus in accordance with company policies.