Insurance Credit Resolution Specialist (Experience with Arizona payers preferred)

Under the direction of the Sr. Manager, Revenue Cycle Management, the Insurance Credit Resolution Specialist is responsible for complete, accurate and timely processing of all assigned insurance related credits. Processing of these credits includes reviewing and responding to daily correspondence from physician practices in a timely manner, answering incoming inquiries, preparing insurance refund checks for mailing, and processing returned checks.  Identify and review patient accounts with insurance overpayments, ensuring accuracy and compliance with payer guidelinesReconcile account balances by applying, transferring, or refunding credits where necessaryAnalyze explanation of benefits (EOBs) and insurance payments to verify credits and resolve discrepanciesProcess refunds for insurance companies in a timely and accurate mannerPrepare and submit refund requests according to established policies and procedures, to include payer specific workflowsEnsure proper documentation and communication regarding refund transactions with all relevant partiesResolve any outstanding credits or account discrepancies by working with insurance companies, patients, and internal teamsEnsure all refund and credit transactions are conducted in compliance with healthcare regulations, including HIPAA and payer-specific guidelines.Maintain detailed records of all credit and refund activities for auditing and reporting purposes.Respond to inquiries regarding refunds, and resolve issues in a timely and customer-focused manner.Be able to meet productivity expectationsUse Salesforce to manage worklists and requests/inquiries from Care Centers