ResponsibilitiesCome and join the RMC Family!
Riverside Medical Clinic has been in the community since 1935. Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Your passion, inspiration, and talents are invaluable to us and our mission to serve others. Our facility can provide a place for you to thrive and continue your professional development. Quality Healthcare is our passion, improving lives is our reward. We are working to change lives and transform the delivery of healthcare.
Riverside Medical Clinic is the best place to work, practice medicine, and receive care.
Summary: The Credit Specialist is primarily responsible for monitoring and resolving credit activity as well as refund request letters received from governmental and commercial carriers. The Credit Specialist will review the accounts to include charges, accuracy of reimbursement and applicable refunds. The Credit Specialist will identify trends, maximize revenue, the root cause for credits, and collaborate with the appropriate parties to maximize revenue.
Qualifications: To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Hours: Monday- Friday 8:00AM- 5:00PM
QualificationsEducation and Experience: High school diploma or GED required. Knowledge of medical terminology required. Three years Customer Service Skills, Two years experience medical billing, collections experience a plus.
Certificates, Licenses and Registrations: None.
Essential Job Functions:
- Investigate & resolve credit invoices and accounts
- Determine the correct course of action to resolve the refund request or credit balance which could include but not limited to:
- Accurate completion of refund request for submission to refund department.
- Requesting payment corrections or adjustment corrections as needed.
- Requesting transfer of patient payments to other patient accounts that have patient balances that may reside in patient accounting system.
- Work closely with third-party payors throughout the refund and credit issue resolution process.
- Maintain knowledge of insurance payments and rejection/denial processes.
- Update credit balance/refund reports as necessary.
- Notify payor representative to initiate takeback (recoupment) and provides support documentation as required to the payor representative.
- Provides all required documentation necessary for refund approval.
- Submits validated refund request documents for Lead review and approval.
- Ensures complete, accurate, and timely account notation and documentation in the patient accounting system, including adjudication and denial processing.
- Works closely with the Team Leads of the Business Office.
- Other Business Office duties responsibilities directed by supervisor may apply.
Other Job Functions:
- Attend staff meetings or other company sponsored or mandated meetings as required.
- Perform additional duties as assigned.
- Special Projects as needed.
- Ability to collaborate & accept direction.
- Ability to manage multiple assignments effectively.
- Organize & prioritize workload.
- Ability to read & interpret EOBs.
This opportunity offers the following:
Challenging and rewarding work environment
Growth and Development Opportunities within UHS and its Subsidiaries
Competitive Compensation
About Universal Health Services
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
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