Credit Balance Analyst
Cancer care is all we do
Hope in healing
Cancer Treatment Centers of America® (CTCA), part of City of Hope, takes a unique and integrative approach to cancer care. Our patient-centered care model is founded on a commitment to personalized medicine, tailoring a combination of treatments to the needs of each individual patient. At the same time, we support patients’ quality of life by offering therapies designed to help them manage the side effects of treatment, addressing their physical, spiritual and emotional needs, so they are better able to stay on their treatment regimens and get back to life. At the core of our whole-person approach is what we call the Mother Standard® of care, so named because it requires that we treat our patients, and one another, like we would want our loved ones to be treated. This innovative approach has earned our hospitals a Best Place to Work distinction and numerous accreditations. Each of us has a stake in the successful outcomes of every patient we treat.
The Credit Balance Analyst (CBA) provides resolution to CTCA hospital and physician accounts with credit balances by determining whether a credit balance is the result of an overpayment, a payment that has been misapplied, a correction in COB (coordination of benefits), an adjustment that needs to be corrected, a billing error, or a combination of these items. The CBA analyzes the data to determine the corrective action needed to zero the account. The CBA reviews and responds to insurance refund requests. The CBA determines the actual amount of a refund and refunds the correct payee. Accounts are researched by reviewing the following: applicable EOB’s, payments, adjustments, benefits, and account comments. The Credit Balance Analyst must perform these duties in a timely and accurate manner. All credit balances must be reconciled within 60 days of identification of the credit balance per regulatory guidelines. Credit Balance Analysts are responsible for validation of credit balance payments to appropriate accounts and must ensure all adjustments are accurate and reasonable. The Credit Balance Analyst reports directly to the Supervisor Credit Balance Analysts.
- Works daily assignment from work queue or as defined by Supervisor.
- Researches all credit balances for all CTCA hospital and physician entities.
- Analyzes the entire patient account which includes all payments, adjustments, insurance verification, billing, and account comments to identify credit balance.
- Resolve the credit balance by completing cash transfers and/or correcting adjustments to and ensuring any overpayments are refunded to the correct payee for the correct amount.
- Updates account comments of each account worked.
- Contacts insurance carrier when needed to expedite research of payments or audits.
- The Credit Balance Analyst must understand and abide by regulatory requirements including resolution of credit balances within 60 days of identification.
- Reviews third party correspondence within 1 business day of receipt and responds within 3 business days and takes appropriate action.
- Receives and responds to refund requests (e.g. phone, mail, email, etc.).
- Reconciles cash unidentified accounts, using balancing and research process.
- Enters appropriate account comments for audit trail, documentation and communication purposes.
- At all times adheres to written CTCA, MRMC, and Patient Accounts specific policies & procedures, CTCA Financial Policies, and all HIPAA rules and regulations.
- Determines correct payee and dollar amount of refunds.
- Prepares check requests and attaches supporting documentation for approval process.
- Maintains proper recordkeeping of completed refund checks and keys refund adjustment to the patient’s account.
- May request duplicate refund check in the event of a lost check.
- Processes refund check adjustments within 3 business days of receipt of check or before month-end, whichever is applicable.
- Maintains patient confidentiality at all times.
Education/ Experience Level
- Must be a High School graduate or equivalent with strong analytical skills. College Degree Preferred.
- Must have minimum of 3-5 years A/R experience in a hospital or physician healthcare setting or similar customer service position.
Knowledge and Skills
- Must be analytical
- Must have good written and verbal communication skills.
- Must have knowledge of medical terminology.
- Knowledge of PC and other office equipment with Windows experience a plus.
- Must have experience with ICD-9 coding, insurance terminology and ability to read an Explanation of Benefits.
- Must have outstanding telephone communication and customer service skills.
- Must be efficient, reliable, goal orientated and adaptable to change while maintaining productivity levels.
- Must be able to perform routine mathematical, color coding and alphabetizing functions.
- Must have excellent organizational skills, and be able to manage multiple priorities.
- Must be Team oriented.
- Must be courteous and professional.
Each CTCA employee is a Stakeholder, driven to make a true difference and help win the fight against cancer. Each day is a challenge, but this unique experience comes with rewards that you may never have thought possible. To ensure each team member brings his or her best self, we offer exceptional support and immersive training to encourage your personal and professional growth. If you’re ready to be part of something bigger and work with a passionate, dynamic group of care professionals, we invite you to join us. Visit: Jobs.cancercenter.com to begin your journey.
We win together
Each CTCA employee is a Stakeholder, driven to make a true difference and help win the fight against cancer. Each day is a challenge, but this unique experience comes with rewards that you may never have thought possible. To ensure each team member brings his or her best self, we offer exceptional support and immersive training to encourage your personal and professional growth. If you’re ready to be part of something bigger and work with a passionate, dynamic group of care professionals, we invite you to join us.
Visit: Jobs.cancercenter.com to begin your journey.