Associate - Payment Posting

Job Title: Credit Balance Review Specialist (US Healthcare)

Department: Revenue Cycle / Billing

Years of Experience: 1-2 Years

Shift Timings: Day Shift (09:00 AM to 06:00 PM)

Mode of interview: In-person.

Mode of operation: Work from office

Location: Hyderabad, Telangana

Reports To: Billing Supervisor or Revenue Cycle Manager

Job Summary:

The Credit Balance Review Specialist is responsible for identifying, analyzing, and resolving credit balances on patient and insurance accounts in accordance with company policies and healthcare regulations. This role ensures accurate account reconciliation, prevents inappropriate refunds, and contributes to the overall financial health of the organization.

Key Responsibilities:

• Review patient and insurance accounts for credit balances to determine the root cause (e.g., overpayments, mispostings, duplicate payments).
• Analyze and research explanation of benefits (EOBs), remittance advice, and billing records to ensure proper application of payments.
• Resolve credits through adjustments, transfers, or refund processing in accordance with payer guidelines and internal policies.
• Communicate with internal departments to resolve credit balance discrepancies.
• Maintain detailed and accurate documentation of all actions taken on each account.
• Ensure timely and compliant processing of refunds when necessary.
• Monitor aging reports and worklists to prioritize and address outstanding credit balances.
• Assist in audits and provide support during internal and external reviews.
• Stay updated with payer policies, HIPAA, and regulatory compliance regarding billing and refunds.

Qualifications:

• Any Degree
• 1–2 years of experience in credit balance review in a US healthcare.
• Strong knowledge of insurance billing, EOBs, and remittance advice.
• Familiarity with federal and state healthcare regulations, including CMS guidelines.
• Proficiency with medical billing software (e.g., NG, Epic, AMD, Centricity) and Microsoft Office Suite (Excel required).
• Strong analytical and problem-solving skills.
• Excellent communication, organizational, and time management abilities.

Preferred Skills:

• Experience in a multi-payer environment (Medicare, Medicaid, commercial insurers).
• Knowledge of refund request procedures and payer-specific policies.
• Ability to work independently and meet deadlines.