OUR COMPANY: Revco Solutions Inc provides best-in-class Revenue Cycle management to Hospital and Physician Service clients.

POSITION DESCRIPTION: This role is responsible for the daily review, research, and resolution of credit balance accounts for both hospital (facility) and physician (professional) billing. This role focuses exclusively on resolving existing credit balances through refunds, reallocations, and adjustments in compliance with payer contracts, regulatory requirements, and organizational policies.

MAJOR AREAS OF RESPONSIBILITIES 

• Work assigned credit balance inventory      queues daily for hospital and physician accounts, prioritizing accounts      based on ageing, dollar amount, payer requirements, and regulatory      timelines.
• Research the root cause of credit      balances, including duplicate payments, overpayments, coordination of      benefits errors, retroactive adjustments, contractual discrepancies, and      posting inaccuracies.
• Determine the appropriate resolution      method for each credit balance, including:
  • Refunds to payers or patients
  • Reallocation of payments to open       balances
  • Contractual or administrative       adjustments, when applicable
• Prepare and submit refund requests with      complete and accurate supporting documentation.
• Review remittance advice (ERAs/EOBs) and      account transaction history to validate overpayment sources and resolution      accuracy.
• Apply credits to the oldest dates of      service first, unless otherwise required by payer or regulatory      guidelines.
• Maintain clear, detailed account notes      documenting research performed, actions taken, and final resolution.
• Monitor payer and regulatory timelines      to ensure timely resolution and avoid compliance risk.
• Escalate complex, high-dollar, or      non-standard credit balance scenarios in accordance with established      workflows.
• Partners with payment posting, insurance      follow-up, billing, coding, and refund teams to resolve credit balances      requiring cross-functional action.
• Identify and report recurring credit      balance drivers, payer trends, or system issues to leadership.
• Support audit requests and quality      reviews by providing account documentation and resolution details.
• Participate in process improvement      initiatives to reduce future credit balance volume.
• Meet or exceed established productivity      standards for credit balance accounts resolved.
• Maintain high accuracy and compliance      with payer contracts, refund policies, and regulatory requirements.
• Ensure timely resolution of credit      balances in accordance with organizational and payer timelines.
• Adhere to documentation, audit, and      compliance standards.

HOURS: Monday-Friday 8:00am-5:00pm EST 

What We Offer:

• Insurance/401k match
• PTO/Paid holidays
• Referral bonuses

 QUALIFICIATIONS:

• High school diploma or equivalent      required.
• 3+ years of healthcare revenue cycle      experience focused on credit balance resolution.
• Strong attention to detail and ability      to work effectively in a fast-paced environment.
• Strong understanding of billing and      collections processes.
• Strong understanding of ERAs/EOBs, payer      contracts, and overpayment resolution workflows.
• Proficiency with patient accounting and      practice management systems.
• Ability to manage high-volume credit      balance inventory independently. Disciplined      work ethic with ability to work remotely with little direct supervision      and meet production targets.
• Analytical and detail-oriented
• Strong prioritization and time      management
• Clear written documentation
• Compliance-focused decision-making
• Collaborative problem-solving

Preferred Qualifications

• Experience with commercial, Medicare,      and Medicaid payers.
• Familiarity with refund processing,      recoupments, and audit standards.
• Experience working in a centralized      business office or large health system.
• Experience with Epic.