Account Credit Resolution Representative II

Position Description :

The Credit Resolution team is responsible to review all unresolved credits and provider level adjustment on professional billing invoices. The team is also responsible to complete internal / external account charge correction requests. All tasks are to be facilitated in accordance with CPS refund policies, governmental regulations and guidelines, and multiple MCW contractual agreements with various insurance carriers.

Hybrid Position : 90% Remote & 10% Onsite

Responsibilities :

• Audit and verify incorrect payment allocation, duplicate payment of service, and payments made to MCW & CP in error. Re-allocate, correct, or refund upon completion of audit.
• Review credits on patient account invoices and utilize internal and external resources and / or call insurance company to retrieve appropriate remittance advice (EOB) for further credit review and determination.
• Reconcile refund request reports generated within team.
• Post and link refund request letters to corresponding invoice
• Review Provider Level Adjustment WQ (PLB) for account / remittance resolution.
• Complete Epic charge corrections on patient accounts based upon request from internal and external departments.
• Apply all CPS refund policies, governmental guidelines, and MCW contractual agreements to determine appropriate action in each situation.
• Provide assistance to the Accounting team and the Posting team as required.
• Complete special projects as assigned by Supervisor.

Knowledge - Skills - Abilities

Preferred Schedule :

Full-time role with expectations for coverage during core business hours and flexibility required as necessary to accommodate business needs.

Position Requirements :

Minimum Qualifications :

Appropriate experience may be substituted for education on an equivalent basis

Minimum Required Education : High school diploma

Minimum Required Experience : 2 years

Preferred Experience :

Experience in medical billing, healthcare revenue cycle, or healthcare reimbursement is preferred. Familiarity with Epic, insurance payments and remittance advice (EOBs), and provider-level adjustments (PLBs) is a plus.

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Why MCW?

For a full list of positions see : www.mcw.edu / careers

For a brief overview of our benefits see : https : / / www.mcw.edu / departments / human-resources / benefits

MCW as an Equal Opportunity Employer and Commitment to Non-Discrimination

The Medical College of Wisconsin (MCW) is an Equal Opportunity Employer. We are committed to fostering an inclusive community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity / expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants, or other members of the MCW community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic.