Accounts Receivable Credit Specialist

 

The Accounts Receivable Credit Specialist is responsible for reviewing and resolving insurance credit balances to ensure accurate account reconciliation and regulatory compliance. This role analyzes credit balances to determine appropriate resolutions, including refunds, transfers, adjustments, or contractual allowance corrections. The specialist identifies trends, investigates root causes, and collaborates with cross-functional teams to reduce future credit balances and improve operational efficiency.

Key Responsibilities

• Review, investigate, and resolve insurance credit balances in a timely and accurate manner.
• Research claim payment discrepancies and determine appropriate corrective actions, including rebilling, adjustments, transfers, or refunds.
• Initiate and process identified overpayment refunds in accordance with company policies and payer requirements.
• Prepare and submit refund requests for approval and maintain supporting documentation.
• Manage payer refund disputes and appeals related to inappropriate refund requests.
• Collaborate