Insurance Credit Resolution Specialist Position Available In Alachua, Florida

Insurance Credit Resolution Specialist The Cardiac and Vascular Institute – 3.0

Gainesville, FL Job Details Full-time Estimated:

$35.4K – $42.6K a year 1 day ago Qualifications Practice management EHR systems HIPAA Mid-level Outpatient High school diploma or GED Analysis skills Cardiology Medical billing Communication skills

Full Job Description Insurance Credit Resolution Specialist Hours of Work:

M-F Employment Type:

Full Time Shift:

Day Overview The Insurance Credit Resolution Specialist is responsible for reviewing and resolving insurance overpayments, with a focus on responding to overpayment demand letters and evaluating credit balances within the practice management system (Intergy). This role plays a critical part in ensuring accurate reconciliation and resolution of insurance credits, minimizing financial risk to the organization.

Key Responsibilities:

Review and resolve insurance credit balances, with a focus on overpayments identified in Intergy. Analyze overpayment demand letters from payers to determine validity and appropriate response. Coordinate and process insurance refunds, recoupments, or reversals in compliance with payer policies. Collaborate with billing, payment posting, and AR teams to identify root causes of overpayments and implement corrective actions. Document all credit resolution activities accurately and thoroughly in the practice management system. Track and monitor aged credit balances to ensure timely resolution. Communicate with insurance companies as needed to resolve discrepancies or clarify overpayment notices. Ensure compliance with federal, state, and payer-specific guidelines related to credit balances and refund processing. Assist with internal audits or payer audits related to credit balances or overpayments. Support ongoing process improvements related to credit resolution workflows.

Qualifications:

High school diploma or equivalent Minimum 2 years of experience in medical billing, insurance follow-up, or revenue cycle operations, preferably in a multi-specialty or outpatient setting. Strong understanding of insurance overpayment and refund processes. Experience with Intergy or similar practice management/EHR system preferred. Excellent attention to detail and analytical skills. Strong written and verbal communication skills. Ability to work independently and manage time effectively. Knowledge of HIPAA regulations and compliance standards.

Working Conditions:

Office environment; may be remote or hybrid based on organizational policy. Standard work hours with occasional extended hours as needed to meet deadlines. Preferred Qualifications Cardiology Experience Additional Information All your information will be kept confidential according to EEO guidelines.