Insurance Credit Resolution Specialist

Job Summary

To support efficient revenue cycle operations, the full-time Insurance Credit Resolution Specialist will manage the processing of insurance-related credits, respond to inquiries, and ensure compliance with healthcare regulations in a hybrid work environment.

Key responsibilities

• Identify and review patient accounts with insurance overpayments, ensuring accuracy and compliance with payer guidelines
• Process refunds for insurance companies in a timely and accurate manner, maintaining detailed records of all credit and refund activities
• Resolve outstanding credits or account discrepancies by collaborating with insurance companies, patients, and internal teams

Required qualifications

• High School Graduate, Medical Office training certificate, or relevant experience
• 3+ years of experience in physician revenue cycle or claims management
• Background in posting charges, claim follow-up, collections, and payment posting
• AthenaOne EMR experience preferred
• Must comply with HIPAA rules and regulations