Credit Specialist

The Credit Specialist is responsible for understanding payor requirements and contracts to determine appropriate next steps to resolve accounts with credit balances. The role involves analyzing and resolving issues related to credit balances, including reviewing reminders from billers, payments, adjustments, and written requests for refunds before preparing the necessary documents for management review and approval. The specialist also makes follow-up phone calls to insurance companies or policyholders when needed regarding credit balances or overpayments. Key responsibilities include researching credit balances, determining the correct course of action to resolve refund requests or credit balances, completing refund requests, requesting payment or adjustment corrections, and requesting the transfer of patient payments. Additionally, the specialist ensures accurate account notation and documentation in EPIC, manages daily work queues, and performs regular reconciliations of patient accounts. The role also requires compliance with CHN and affiliate policies, as well as state and federal regulations, and a commitment to Planned Parenthood’s mission related to health equity.