Credit Balance Analyst
Children's National Medical Center | |
United States, Maryland, Silver Spring | |
801 Roeder Rd #300 (Show on map) | |
Aug 28, 2024 | |
Description
Responsible for timely research and resolution of insurance credit balances on highly complex cases. Performs necessary functions to refund overpayments from insurance carriers within 30 days of receipt. Manage work queues related to insurance overpayments and insurance credit balances. Identify trends, potential resolutions and escalate to manager. Evaluate accuracy of contract modeling, communicate findings, and escalate as appropriate. Responsible for reporting state Medicaid's credit balances on a quarterly basis. Participate in payer meetings to resolve issues. Responsible for ensuring solutions implemented and goals achieved. Identify and monitor CMS & payor rule changes and work to ensure compliance.
Qualifications
Minimum Education
Bachelor's Degree (Preferred) Minimum Work Experience 3 years Related patient accounting experience required, especially related to insurance overpayments trending and root cause analysis (Required) Required Skills/Knowledge Excellent working knowledge of complex contract reimbursement methodologies including transplant, global, APR DRGs among others. Proven analytical skills including ability to make recommendations based on financial analysis. Excellent PC skills including advanced skill proficiency in Access and Excel spreadsheet analysis. Ability to work in a team environment with other analysts, managers, and department leaders. Proficiency in presentation of analytical results. Excellent working knowledge of coding & NCCI edits. Demonstrated knowledge of managed care payer requirements in an acute hospital setting. Demonstrated ability to facilitate team or group activities. Excellent verbal and written communication skills. Demonstrated ability to be flexible and to prioritize workload & decision-making skills. Ability to analyze workflow for process improvement. Strong organizational and coordination skills required. Functional Accountabilities Account Follow-up
Organizational Accountabilities Track Refunds
Organizational Commitment/Identification
Teamwork/Communication
Performance Improvement/Problem-solving
Cost Management/Financial Responsibility
Safety
Primary Location
:
Maryland-Silver Spring
Work Locations
:
Tech Hill
12211 Plum Orchard Drive
Silver Spring
20904 Job
:
Accounting & Finance
Organization
:
Finance
Position Status
:
R (Regular)
-
FT - Full-Time
Shift
:
Day
Work Schedule
:
8:30 - 5:00pm
Job Posting
:
Aug 28, 2024, 4:04:08 PM
Full-Time Salary Range
:
48588.8
-
80974.4 |