Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 providers offering primary and specialty care along with hospital-based services in the region.
The Credit Balance Specialist performs all hospital and professional billing credit balance resolution tasks assigned by the Credit Balance Resolution Coordinator. Responsibilities include researching credit balances, providing supporting evidence, communicating findings, and performing necessary billing system adjustments to resolve credit balances. The role prepares, submits, and ensures completion of refunds and retractions to resolve credit balances.
Essential functions encompass managing credit balances for various insurers and third-party payors, collaborating with billing and cash applications staff as needed, reviewing billing systems, cash posting reports, EOBs, claims documentation, and liaising with insurance customer service for thorough research. The specialist tracks credit balance data to identify risks, reviews payment variances, performs root cause analysis on adjustments, supports projects with payer documentation, and undertakes other assigned duties.
The position requires one year experience in accounting, finance, or healthcare Revenue Cycle billing operations, knowledge of Revenue Cycle billing functions such as pre-bill edits, claim submission, accounts receivable, and payment posting. Experience with Excel and end-user familiarity with Epic, Athena, or Cerner is preferred.
The scheduled weekly hours are 40, with an 8-hour usual work day.
The role demands physical activities including keyboard use, sitting, standing, walking, and lifting up to 15 lbs. Sensory abilities required include accurate vision and minimal hearing. No anticipated occupational exposure risks.
Capital Health offers benefits including medical, dental, vision plans, flexible spending accounts, retirement plans, life and disability insurances, employee assistance programs, commuter benefits, and paid time-off.
- High school diploma or equivalent.
- One year experience in accounting, finance, or healthcare Revenue Cycle billing operations.
- Knowledge of Revenue Cycle billing functions such as pre-bill edits, claim submission, accounts receivable, or payment posting.
- Experience working in Excel.
- Preferred experience as an end user in Epic, Athena, or Cerner.
- Ability to work independently, take direction, meet deadlines, and conduct research.
- Medical Plan, including Prescription drug coverage and In-House Employee Pharmacy
- Dental Plan
- Vision Plan
- Flexible Spending Accounts (Healthcare and Dependent Care)
- Retirement Savings and Investment Plan
- Basic and Supplemental Group Term Life and AD&D Insurance
- Disability Benefits (Long Term and Short Term)
- Employee Assistance Program
- Commuter Transit and Parking
- Supplemental Life Insurance options (Voluntary Life Spouse, Employee, Child)
- Voluntary Legal Services
- Voluntary Accident, Critical Illness, and Hospital Indemnity Insurance
- Voluntary Identity Theft Insurance
- Voluntary Pet Insurance
- Paid Time-Off Program
Location
New Jersey, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
2 weeks ago