Provides the necessary functions to bill, collect, analyze, and adjudicate all hospital and professional accounts and functions within the Geisinger Health System. This position executes and performs programs to insure efficient operations of the Geisinger Health System Revenue Management program in order to resolve credit balances to support GHS operations and strategic initiatives. In the position of Revenue Management Credit Balance Specialist, responsibilities include resolving credits for all patients and third party insurance payers, cash application, adjudicating, identifying, analyzing and associated with approximately $30 million of hospital and professional accounts.
Reports to the Revenue Cycle Credit Balance Manager.
Competencies and Skills:
Demonstrates strong mathematical skills.
Demonstrates excellent communication skills, strong organizational skills, interpersonal skills, and writing skills. Demonstrates the ability to work independently and as a member of a team.
Demonstrates an extensive understanding of billing, insurance reimbursement and credit balance resolution processes.
Demonstrates the ability to effectively communicate in a positive and team oriented environment. Demonstrates familiarity with multiple computerized applications (i.e. Siemens, IDX, Tower, Contract Manager,
Cadence, Epic, Electronic Medical Health Record, ePremise, NaviNet, Artiva, etc).
Performs all areas of job functions at a high accuracy rate; with minimal supervision.
Organizes work to effectively utilize time management and maintain workloads at a current status.
Demonstrates the ability to work well in a team atmosphere fostering a positive, professional relationship with all staff across department and company lines.
EDUCATION AND/OR EXPERIENCE:
Bachelor's degree in related field preferred.
High School diploma or equivalent required. Minimum of three years of revenue management or related financial/accounting experience required.
Credit Balance Specialist I must be in their current position for two years before being considered for the Credit Balance Specialist II position; or have a minimum of three years of credit balance, revenue management or related financial/accounting experience.
Extensive knowledge of the revenue management and/or regulatory requirements as they relate to the hospital and professional billing and reimbursement for all third party insurance payers, revenue enhancement and the cash application component for the various service lines contained within GHS and the revenue management preferred. Experience within a similar setting of size or volume preferred.
Extensive experience with payers, providers, hospitals and physicians and understand the commensurate requirements for facilitating accounts receivable resolution by service line including cash flow, billing, collection, cash application and customer service related issues preferred.
Experience with IDX, BAR and Siemens applications required in resolving credit balances.
Experience within a centralized business office preferred.
Minimum of one year to learn all job functions regarding job responsibilities and requirements.
Work is typically performed in an office environment.
The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
One of the nation’s most innovative health services organizations, Geisinger serves more than 1.5 million patients in Pennsylvania and New Jersey. The system includes 13 hospital campuses, a nearly 600,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. A physician-led organization, with approximately 32,000 employees and more than 1,800 employed physicians, Geisinger leverages an estimated $12.7 billion positive annual impact on the Pennsylvania and New Jersey economies. Repeatedly recognized nationally for integration, quality and service, Geisinger has a long-standing commitment to patient care, medical education, research and community service. For more information, visit geisinger.org or connect with us onFacebook, Instagram, LinkedInand Twitter.
** Does not qualify for J-1 waiver. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
*Domestic partner benefits not applicable at Geisinger Holy Spirit.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencing
programs, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.
Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.