Credit & Refund Specialist

Location: 7000 Calmont Ave, Fort Worth Pay: 28-30/HR on W2Job Summary: The Credit & Refund Specialist is responsible for managing the credit balance process, ensuring accurate and timely resolution of credit balances and refunds in compliance with policies and regulatory guidelines. The Credit & Refund Specialist will work closely with the revenue cycle team, billing department, payers, and patients to investigate and resolve credit balances efficiently. The Cook Children's Cash Management, Customer Service, Document Control, Financial Counseling, and Revenue Cycle Analytics/Integrity departments function as a part of a Single Billing Office (SBO) that supports all of Cook Children's Health Care System. The ultimate goal of the SBO is to integrate customer Service and self-pay collection activities across Cook Children's Medical Center and Cook Children's Physician Network, providing a single point of contact, a single patient billing statement and increased transparency to guarantors thereby improving the patient collection process and patient experience.

Required Skills & Experience: Three (3) years of progressive experience working third party insurance, hospital-based claims follow-up, cash posting and/or general ledger accounting in a healthcare setting. Basic knowledge of Epic Systems and/or OnBase. Understanding medical terminology, hospital-based medical billing practices and billing reimbursement. A strong customer service background and knowledge of insurance policies required. Excellent human relations skills. Strong analytical skills and attention to detail. Excellent communication and interpersonal skills. Computer Skills: Strong keyboarding skills and working knowledge in use of all Microsoft Office applications, specifically Word and Excel proficiency. Internet proficiency and knowledge of email management tools are essential. Detail oriented, good organizational skills and ability to be self-directed. Understanding of insurance payment posting, contractual adjustments, and denials. Familiarity with Medicare, Medicaid, and commercial insurance billing regulations. Working knowledge of Explanation of Benefits (EOB) and ability to interpret remittance advice to resolve insurance debit/credit balance. Ability to identify and resolve complex credit balance issues. Understanding of regulatory requirements related to credit balance resolution. Demonstrated ability to communicate effectively with patients/guarantors and insurance companies. Collaborate effectively with colleagues to achieve common goals. Flexibility to adjust to changing priorities and workloads. Ensure accuracy in credit balance resolution processes. Prioritize tasks and meet deadlines efficiently. Proactively seek opportunities to enhance processes and outcomes.

Required Education: High school diploma or equivalent. Preferred Education: Associates Degree with three (3) years of progressive experience working third party insurance, hospital-based claims follow-up, cash posting and/or general ledger accounting in a healthcare setting.