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Credit Management Representative

Med-Metrix

Red Bank, NJ

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JOB DETAILS
SALARY
$18–$20 Per Hour
JOB TYPE
Full-time
SKILLS
Analysis Skills, Authentication, Business Support, Claims Processing, Communication Skills, Credit and Collections, Current Procedural Terminology (CPT), Customer Support/Service, Database Backup, Estimation of Benefits (EOB), Genetics, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, Healthcare Reimbursement, ICD-10, Information/Data Security (InfoSec), Insurance, Interpersonal Skills, Microsoft Excel, Microsoft Product Family, Military, Office Equipment, Organizational Skills, Payment Posting, Peripheral Hardware, Policy Development, Presentation/Verbal Skills, Problem Solving Skills, Procedure Development, Reimbursement, Root Cause Analysis, Security Compliance, Smartphones, Spreadsheets, State Laws and Regulations, Support Documentation, Team Player, Time Management, Trend Analysis, Writing Skills
LOCATION
Red Bank, NJ
POSTED
13 days ago
Job PurposeThe Credit Management Representative is responsible for all elements of Credit Balance Management which include but is not limited to: Triaging patient and insurance credit balance to determine root cause, correcting contractual/manual adjustments, identifying overpayments and creating refund requests including appropriate documentation to support refund, identifying posting/payer trends and communicating to management for resolution.Duties and ResponsibilitiesPerform credit balance management for multiple clientsReview daily credit balance work list to imitate research of credit balance accountsResearch, identify root cause, and resolve patient accounts including but not limited to posting errors, insurance overpayments, patient overpayments, and/or system issuesPrepare and submit refund requests as appropriate obtaining all pertinent back-up data including EOBs, insurance company correspondence, refund letter of explanation and explanation of reimbursement from practice management system.Correct all misapplied contractual adjustmentsPrepare spreadsheets for payers regarding special projects involving erroneous refunds and payer retractionsReview payer refund request letters and take appropriate action to resolve and respond timely.Maintain WQ’s assigned to ensure accounts are worked in a timely manner.Identify trends and escalate to supervisorAdhere to unique client specific assigned workflows & tasksCollaborate effectively with co-source partners, and other functional teams supporting the business.Responsible for retrieving EOB’s to post payments & denialsUses the MCX workflow system, client host system, payer websites and other tools availablePerform special projects and other duties as needed. Assists with special projects by utilizing excel spreadsheets, and the ability to communicate results.Meets and maintains daily productivity standards established in departmental policiesAdheres to the policies and procedures established for the client/teamAlways maintain confidentialityMaintain a professional attitudeOther duties as assigned by the management teamUse, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standardsUnderstand and comply with Information Security and HIPAA policies and procedures at all times Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties QualificationsHigh School diploma or equivalent required1-year experience in insurance collections, credit balance management and or payment posting1-3 years experience in Physician/Professional billingWorking knowledge of the insurance follow-up process with the understanding of the fundamental concepts in healthcare reimbursement methodologiesUnderstanding an EOB and what the remarks or denials meanWorking knowledge of the insurance follow-up process with the understanding of the fundamental concepts in healthcare reimbursement methodologiesBasic knowledge of healthcare claims processing including ICD-10, CPT, and HCPC codesAbility to work well individually and in a team environment.Proficiency with Microsoft OfficeStrong communication skills/oral and writtenStrong organizational skillsStrong interpersonal skills, ability to communicate well at all levels of the organization Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses High level of integrity and dependability with a strong sense of urgency and results oriented Excellent written and verbal communication skills required Gracious and welcoming personality for customer service interaction Working ConditionsMust possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes. Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.Work Environment: The noise level in the work environment is usually minimal.Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

About the Company

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Med-Metrix