Insurance Credits Specialist

Location: United States

Company

hirify.global supports community oncologists through a patient-centric, physician-driven, and technology-powered healthcare model.

What you will do

• Evaluate daily credit balances created during payment posting.
• Research credit balances and refund requests to identify the appropriate overpaid party.
• Prepare refund requests for Accounts Payable approval, check issuance, payer offsets, or written disputes.
• Maintain completed-request batch files and verify that overpayments have been resolved.
• Identify payment-posting issues and report payer-related problems to the Team Leader for audit purposes.
• Coordinate with Registration, Front Office, Accounts Payable, and other departments to resolve credit balances and refund requests.

Requirements

• High school diploma or equivalent.
• At least one year of directly related experience.
• Medical billing experience, including detailed knowledge of HCPCS, CPT, and ICD codes.
• Knowledge of coordination of benefits rules and the ability to determine legitimate credits.
• Strong analytical, organizational, multitasking, communication, negotiation, and problem-solving skills.
• Proficiency with Microsoft Word, Excel, Outlook, databases, patient billing systems, and other medical information systems.

Nice to have

• Previous experience with credits and refunds.
• Experience using managed care profiles, AWP grids, Issue Assistance, and related billing tools.

Culture & Benefits

• Values-driven environment with startup enthusiasm and support from leaders in oncology, urology, technology, and finance.
• Work focused on improving processes that support independent physicians and their patients.
• Professionalism, adaptability, initiative, mature judgment, and customer-service orientation are expected.