Tennessee Orthopaedic Alliance

  • Credit Balance Specialist

    Job Locations US-TN-Nashville
    Posted Date 2 weeks ago(5/7/2018 12:33 PM)
    Job ID
    # of Openings
    Central Business Office
  • Overview

    The Credit Balance Specialist is an important part of the TOA Central Business Office, our operation that focuses on revenue cycle excellence. As a Credit Balance Specialist, you will use your analytical, financial, and customer service skills to ensure that the accounts of our TOA patients are accurate and reconciled in a timely fashion. Essentially, you’ll be working to make sure any overage that is due to a TOA patient is returned to them timely.   This position reports to our Revenue Cycle Manager, and is located at our Central Business Office location.


    The Credit Balance Specialist focuses on reviewing patient accounts, verifying the transactions, evaluating if an adjustment is to be made, and expeditiously bringing any credit balance to resolution.

    • Meets quality assurance and productivity standards by identifying, reconciling credit balance accounts and reviewing credit balance reports for potential overpayments.
    • Ensures accuracy of refund requests by doing the appropriate research and reconciliation of credit balance accounts and analyzing patients’ accounts utilizing our Electronic Health Record (EHR) system - NextgGen to determine appropriate action.
    • Communicate with patients, TOA staff and insurance payers to ensure timely and accurate resolutions of account transactions. This may include the review of third party claims (i.e. MVA settlements, workers compensation claims.)
    • Prioritize assigned accounts to maximize aged accounts receivable resolution
    • Review explanation of benefit (EOB) documentation and third party claims/workman’s comp. to perform account resolution
    • Process, post, and prepare approved refunds through our EHR system
    • Operate within established guidelines and protocols, including providing backup documentation for our accounting and audit functions


    Required Experiences and Qualifications

    At TOA, our patients deserve the best care, and that extends beyond the clinic to include how we handle our business administration activities. Our team is among the best in Nashville, and that is because we look for the best.

    • College is preferred, and a high school diploma or equivalent is required.
    • At least one year medical office – revenue cycle experience is preferred, with some experience with an orthopaedic practice a plus
    • Exceptional customer service and patient focus. Our Credit Balance Specialists often speak with our patients, providers, and payors, and it is essential that they are able to make each encounter as positive as possible.
    • Knowledge of Insurance - particularly health insurance provisions is essential, accounts payable and accounts receivable is preferred.
    • Knowledge of administrative and clerical procedures, including experience with computer systems. Experience with an EHR or NextGen is a plus
    • An exceptional focus on attention to detail, ensuring that all documentation is entered accurately and swiftly, and that each transaction is reconciled correctly.
    • Collaboration, working closely with Central Business Office and clinical olleagues and administrative team mates to develop a cohesive, high performing team
    • An energetic and enthusiastic pace at work, with the ability to swiftly and accurately manage the flow documents through our EHR, without any diminishing focus on accuracy

    Dependability, with a reliance on the capacity to be at work on-time, every day so our patients can receive the administrative support they need in a timely manner


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