Credit Balance Specialist-Full Time-Days
Cape Fear Valley Health
Summary
Analyzes all credit balances before a refund or adjudication is considered and/or processed. Analyzes accounts for posting errors and may assist with the Medicaid/Medicare Quarterly Credit Balance Reports to include all entities. Performs duties while remaining compliant to all CMS and Cape Fear Valley Health Compliance guidelines. May assist with the preparation of the annual Escheatment Report to ensure all North Carolina Escheatment processes are followed.
Job description
Summary
Analyzes all credit balances before a refund or adjudication is considered and/or processed. Analyzes accounts for posting errors and may assist with the Medicaid/Medicare Quarterly Credit Balance Reports to include all entities. Performs duties while remaining compliant to all CMS and Cape Fear Valley Health Compliance guidelines. May assist with the preparation of the annual Escheatment Report to ensure all North Carolina Escheatment processes are followed.
Major Job Functions
- Identifies and reviews accounts for proper resolution by balance transfer, adjustment or refund to the proper entity
- Determines if a refund is needed and follows correct procedure for completing refund request and any necessary paperwork for the Accounts Payable Department
- Calls insurance companies regarding any discrepancy in payments or coordination of benefits if necessary
- Calls patient regarding any discrepancy in coordination of benefits if necessary
- Follows proper procedure for forwarding accounts to other departments for resolution if needed
- Reviews incoming refund requests for accuracy and processes refunds
- Other duties as assigned
Minimum Qualifications
The following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job:
Education and Formal Training
- High school diploma or equivalent required
Work Experience
- 2 years clerical experience preferably in a hospital business office or accounting department preferred
Knowledge, Skills, and Abilities Required
- Proficiency in reading, writing, and speaking the English language
- Clerical perception required for detecting errors in computation and posting
- Ability to pass a Windows aptitude test and 10-key calculator test
Physical Requirements
- Near visual acuity for reading various records
- Numerical ability and keying of data quickly and accurately
- Motor coordination and finger dexterity
- Good communication skills both oral and written
Requirements
- High school diploma or equivalent required
- 2 years clerical experience preferably in a hospital business office or accounting department preferred
- Proficiency in reading, writing, and speaking the English language
- Clerical perception required for detecting errors in computation and posting
- Ability to pass a Windows aptitude test and 10-key calculator test
- Near visual acuity for reading various records
- Numerical ability and keying of data quickly and accurately
- Motor coordination and finger dexterity
- Good communication skills both oral and written
Company overview
Cape Fear Valley Health is a comprehensive regional healthcare system based in Fayetteville, North Carolina, serving southeastern North Carolina and surrounding regions. Established in 1956, it has grown to become North Carolina's 8th largest health system, operating as a private not-for-profit organization with 7,500 employees and over 1,000 physicians. The system encompasses eight hospitals with 988 total beds, including Cape Fear Valley Medical Center, Highsmith-Rainey Specialty Hospital, Bladen County Hospital, Hoke Hospital, and Harnett Health facilities. Annually, the system serves more than 1 million inpatient and outpatient visits across its network of over 150 locations. Cape Fear Valley Health specializes in cardiac care, cancer treatment, surgical services, neuroscience, pediatrics, rehabilitation, orthopedics, and behavioral health. The organization has earned numerous national recognitions including Healthgrades Top 100 Hospital for Cardiac Care, IBM Watson Top 50 Cardiovascular Hospital, and The Leapfrog Group Grade-A for Patient Safety. With a mission to provide exceptional healthcare for all patients, the system emphasizes patient-centered care, innovation, and community service while maintaining multiple disease-specific certifications from The Joint Commission.