Credit Balance Specialist

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    "description": "<p><span style=\"font-size:12pt\"><span style=\"font-family:Aptos\">We are seeking a detail-oriented and organized <b>Overpayment Refund Specialist</b> to join our ambulance billing team. This role is responsible for identifying, validating, disputing when appropriate, and processing overpayment refunds to insurance carriers, government payers, and patients while ensuring compliance with federal, state, and payer-specific regulations.</span></span></p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><span style=\"font-size:12pt\"><span style=\"font-family:Aptos\"><b>Key Responsibilities</b></span></span></p>\r\n\r\n<ul>\r\n\t<li><span style=\"font-size:12pt\"><span style=\"tab-stops:list .5in\"><span style=\"font-family:Aptos\">Identify and research overpayments from Medicare, Medicaid, commercial insurers, and private pay patients</span></span></span></li>\r\n\t<li><span style=\"font-size:12pt\"><span style=\"tab-stops:list .5in\"><span style=\"font-family:Aptos\">Validate overpayment amounts and determine appropriate refund or dispute actions</span></span></span></li>\r\n\t<li><span style=\"font-size:12pt\"><span style=\"tab-stops:list .5in\"><span style=\"font-family:Aptos\">Prepare and submit disputes or appeals for incorrect or duplicate overpayment demands</span></span></span></li>\r\n\t<li><span style=\"font-size:12pt\"><span style=\"tab-stops:list .5in\"><span style=\"font-family:Aptos\">Review payer recoupment requests and correspondence to determine validity</span></span></span></li>\r\n\t<li><span style=\"font-size:12pt\"><span style=\"tab-stops:list .5in\"><span style=\"font-family:Aptos\">Process approved refunds accurately and in a timely manner, including documentation and tracking</span></span></span></li>\r\n\t<li><span style=\"font-size:12pt\"><span style=\"tab-stops:list .5in\"><span style=\"font-family:Aptos\">Communicate with insurance carriers, patients, and internal teams regarding refund and dispute status</span></span></span></li>\r\n\t<li><span style=\"font-size:12pt\"><span style=\"tab-stops:list .5in\"><span style=\"font-family:Aptos\">Monitor dispute outcomes and follow up to ensure timely resolution</span></span></span></li>\r\n\t<li><span style=\"font-size:12pt\"><span style=\"tab-stops:list .5in\"><span style=\"font-family:Aptos\">Ensure compliance with CMS, state regulations, and payer-specific refund and dispute timelines</span></span></span></li>\r\n\t<li><span style=\"font-size:12pt\"><span style=\"tab-stops:list .5in\"><span style=\"font-family:Aptos\">Maintain accurate records and audit trails for all refunds and disputes</span></span></span></li>\r\n\t<li><span style=\"font-size:12pt\"><span style=\"tab-stops:list .5in\"><span style=\"font-family:Aptos\">Collaborate with billing, compliance, and collections teams to prevent future overpayments</span></span></span></li>\r\n\t<li><span style=\"font-size:12pt\"><span style=\"tab-stops:list .5in\"><span style=\"font-family:Aptos\">Assist with internal and external audits related to overpayments, refunds, and disputes</span></span></span></li>\r\n\t<li><span style=\"font-size:12pt\"><span style=\"tab-stops:list .5in\"><span style=\"font-family:Aptos\">Prepare reports on refund and dispute trends, volumes, and root causes</span></span></span></li>\r\n</ul>\r\n",
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