Guidehouse
Healthcare
CreditBalanceSpecialist
Neural analysis suggests this role is
optimal for Entry candidates.
“Credit Balance Specialist at Guidehouse. Skills: Credit Balance Management, Revenue Cycle Understanding, Patient Account Resolution, Refund Processing, Inter-departmental Collaboration. Manage credit balance workloads of patients. Respond/follow-up on external and internal inquiries”
What You'll Achieve.
Aim to have patient accounts balance to zero prior to accounts being forwarded to an outside agency for collections.
Industry & Context.
Research and resolve patient credit balance accounts; Analyze overpayments, duplicate payments, coordination of benefits (COB), retro eligibility, and contractual adjustment discrepancies; Resolve unidentified payments through research
Individuals must be able to work an eight hour shift between the hours of 8:30 AM CT - 5:30 PM CT, no remote work initially BUT an opportunity for some hybrid (in office/remote) schedules after training., open to relocation to San Antonio
What They're Looking For.
Must Have
High School Diploma / GED, 1+ years of working with credit balance accounts (refund, overpayment, underpayment, accounts resolution, etc.), Working knowledge can be of the following: health insurance claims, medical billing, medical coding, credit finance, accounting or customer service-related responsibilities.
Nice to Have
Credit balance experience within a hospital background, Experience working within Epic, Meditech or other hospital patient accounting systems., Ability to interpret UB-04 claims, payer correspondence, and contractual agreements., Basic knowledge of Commercial, Managed Care, Medicare and Medicaid insurance, PC skills in a Windows environment., Knowledge and utilization of desktop applications to include Word and Excel., Ability to initiate and follow through on projects and work independently with minimal supervision.
What You'll Do.
Manage credit balance workloads of patients
Respond/follow-up on external and internal inquiries
Research and resolve patient credit balance accounts
coordination of benefits (COB)
and contractual adjustment discrepancies
Process patient refunds accurately and timely
Communicate with patients regarding refund status
and payment discrepancies
concise and complete account notes and other relevant information
Resolve unidentified payments through research
Aim to have patient accounts balance to zero prior to accounts being forwarded to an outside agency for collections
Assist with internal and external audits related to credit balance processes and refund activity
How You'll Work.
Team & Collaboration
Collaborate with billing, cash posting, denial management, and patient access teams to resolve account discrepancies.
Communication Scope
Communicate with patients regarding refund status, account balances, and payment discrepancies professionally and compassionately.
Process & Methodology
Ability to initiate and follow through on projects
Full Job Description
**_Job Family_ :** PFS General ** _Travel Required_ :** None ** _Clearance Required_ :** None ** _What You Will Do:_** The**Credit Balance Specialist** **(Hospital Claims)** will manage credit balance workloads of patients and respond/follow-up on external and internal inquires in a timely manner. This person should have a solid understanding of the Revenue Cycle as it relates to the entire life of a patient account from creation to payment. **_Individuals must be able to work an eight hour shift between the hours of 8:30 AM CT - 5:30 PM CT, with no remote work initially BUT an opportunity for some hybrid (in office/remote) schedules after training._** **_We will consider individuals open to relocation to San Antonio!_** **Additionally, the Credit Balance Specialist will:** * Research and resolve patient credit balance accounts resulting from overpayments, duplicate payments, financial assistance adjustments, or insurance reprocessing. * Analyze overpayments, duplicate payments, coordination of benefits (COB), retro eligibility, and contractual adjustment discrepancies. * Collaborate with billing, cash posting, denial management, and patient access teams to resolve account discrepancies. * Process patient refunds accurately and timely in accordance with client policies and regulatory requirements. * Communicate with patients regarding refund status, account balances, and payment discrepancies professionally and compassionately. * Maintain accurate, clear, concise and complete account notes and other relevant information. * Resolve unidentified payments through research. * Aim to have patient accounts balance to zero prior to accounts being forwarded to an outside agency for collections. * Assist with internal and external audits related to credit balance processes and refund activity. **_What You Will Need_ :** * High School Diploma / GED. * 1+ years of working with credit balance accounts (refund, overpayment, underpayment, accounts resolution, etc.) * Working know
Applying for this Credit Balance Specialist role?
Most applicants get filtered before a human reads their resume. See if yours makes the cut.
How to Apply on Workday
- Workday has a multi-step form — save your progress after every section.
- "Apply With LinkedIn" can fail or lose data; manual entry is more reliable.
- Watch for the "Submit for Review" final step — hitting "Save" alone does not submit.
- Job requisition numbers are useful when following up with HR by email.
ANONYMOUS · UNFILTERED
What do employees actually say about Guidehouse?
Real rants from real employees. Read before you apply.