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Our team is seeking a detail-oriented Revenue Cycle Credit Balance Specialist to focus on investigating and resolving insurance credit balances, with a core emphasis on the accurate processing of overpayment refunds to insurance payers. This is an essential finance and operations support role within the healthcare sector, ensuring compliance, financial accuracy, and payer satisfaction.
Job Responsibility
Analyze and monitor insurance credit balances, identifying instances where DaVita has billed a payer and received more funds than expected
Conduct thorough research and investigation on claims to determine the root cause of credit balances and whether they are the result of a true misbalance or other factors
Evaluate if overpayments are owed back to payers and ensure proper adjustment and documentation steps are taken
Process retractions, communicate directly with insurance payers by phone, and utilize payer portals to support and document claim resolution activities
Work with common insurance forms and electronic remittance advices (ERAs) to validate payment postings and adjustments
Apply strong critical thinking skills to interpret payment discrepancies and resolve outstanding credit balances in a timely manner
Participate in a structured training program, spending half the day in classroom learning and half the day on the floor with hands-on experience
Requirements
Prior experience in healthcare revenue cycle, insurance follow-up, medical billing, or claims research is highly preferred
Familiarity with payer policies, insurance remittance forms, and electronic claim systems
Exceptional attention to detail, analytical ability, and strong communication skills
Comfortable navigating payer portals and conducting professional outreach to insurance contacts
Ability to adapt to training environments and learn new systems efficiently