Huron Consulting Group Credit Balance Specialist, Healthcare Managed Services (remote DBO) in Chicago, Illinois
Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.
Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.
Joining the Huron team means you’ll help our clients stabilize their business operations today and create tomorrow’s growth by implementing revenue enhancement and cost containment programs, upgrading technology systems, creating stronger leaders and improving outcomes for patients.
Join our team as the expert you are now and create your future.
The Credit Balance Specialist supports the Revenue Cycle by accurately analyzing posted transactions to determine why there is a credit balance and is responsible for accurate completion and resolution of potential credit balances for health plan payers and patients/guarantors. This position requires detailed analysis and critical thinking to determine what is necessary to correct an account. After review, if 1) a refund is appropriate to either the patient or insurance company, 2) a payment transfer is necessary, or 3) a reversal or correction of a contractual allowance or an administrative adjustment is warranted, then the representative is responsible to correct the postings and/or refund the overpayment to the correct payer(s). In addition, the Credit Balance Specialist ensures proper account documentation within the facility’s systems and pursues follow-up efforts on credit balances under the supervision of the department leaders. This role is a remote position supporting a virtual business office. As such, this role requires frequent and effective communication via phone, email, and instant messaging with the various engagement teams. Strong oral and written communication skills, analytical skills, ability to work independently, and be self-motivated are required.
Generates refund requests and routes resolution to accounts payable for patients and third-party payers
Refunds overpayments and/or transfers payments to the appropriate account/accounts.
Enters refunds into the patient accounting system
Researches and resolves unapplied activity accounts
Documents any request or concern received via mail, e-mail, telephone, written correspondence, or in person on the patient's account
Responsible for responding to insurance/patient requests for refunds in a timely manner (within 24 hours of receipt of message for phone calls)
Identifies the originating cause of the need for a refund, and compiles a report of recurring issues to Management
Responsible for correcting errors in the calculation and posting of insurance contractual adjustments
Compiles credit balance reports for accounts that will be refunded and/or have been refunded
Completes documentation of daily activities for individual productivity tracking and for patient account volume management
Cross-trains in other related business office functions to ensure smooth operation of the department
Maintains confidentiality of all protected health information (PHI)
Performs all job functions in a manner consistent with Huron’s expectations as defined in Huron’s mission statement and values
Coordinates as required with other departments to resolve claim issues and discrepancies
Documents activity on patient account, ensures compliance with all applicable regulations
Reports all identified compliance risks to appropriate leadership
Other duties and responsibilities as assigned.
Two years of appropriate work experience that would indicate a high level of communication skills and knowledge of the modern revenue cycle
Experience with analyzing explanation of benefits (EOBs) from various insurance companies/payers
One year of experience in accounting or bookkeeping; handling cash and/or cash reconciliation in a healthcare facility or hospital, retail business, or bank preferred
Broad Knowledge of Government Programs and Insurance Regulations
Knowledge, Skill, and Ability Requirements
Proficiency with Microsoft office suite (Excel, Word, PowerPoint, Outlook, Visio, SharePoint)
Ability to pay close attention to details; strong follow-up and follow-through skills
Requires the use of independent judgment, discretion and decision-making abilities
Possesses excellent organizational and time management skills
Possesses ability to prioritize tasks, carry out assignments independently and within a team, and to practice good judgment
Ability to interact with internal and external customers in a professional manner
Ability to ramp up on a client’s environment, processes, historical context, and systems to provide support to an engagement as soon as possible
Demonstrates a solid understanding of and adheres to all Huron Healthcare compliance program requirements
United States of America
Huron Consulting Group offers a competitive compensation and benefits package including medical, dental, and vision coverage to employees and dependents; a 401(k) plan with a generous employer match; an employee stock purchase plan; a generous Paid Time Off policy; and paid parental leave and adoption assistance. Our Wellness Program supports employee total well-being by providing free annual health screenings and coaching, bank at work, and on-site workshops, as well as ongoing programs recognizing major events in the lives of our employees throughout the year. All benefits and programs are subject to applicable eligibility requirements.
Huron is fully committed to providing equal employment opportunity to job applicants and employees in recruitment, hiring, employment, compensation, benefits, promotions, transfers, training, and all other terms and conditions of employment. Huron will not discriminate on the basis of age, race, color, gender, marital status, sexual orientation, gender identity, pregnancy, national origin, religion, veteran status, physical or mental disability, genetic information, creed, citizenship or any other status protected by laws or regulations in the locations where we do business. We endeavor to maintain a drug-free workplace.
Huron Consulting Group
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