Revenue Cycle - Credit Balance Resolution Specialist

Perimeter Healthcare Mission and Values

Perimeter Healthcare is one of the leading behavioral health care providers in the country for children, adolescents, adults, and senior adults. We deliver hope to our patients through the delivery of comprehensive and dedicated treatment programs. Our focus and commitment on service excellence is available across several states and in different care settings. Our team ensures our patients receive the required care that they or their loved one needs. We offer several programs for our patients including inpatient acute treatment and residential treatment. We are seeking staff who exhibit daily the following values:

· C- Compassion

· A- Accountability

· R- Respect

· E- Empowerment

Job Summary:

The Credit Balance Resolution Specialist is responsible for investigating, analyzing, and resolving credit balances on patient and insurance accounts to ensure accurate and compliant financial transactions. This role involves reviewing payments, reviewing adjustments, and remittances, to determine if the credit is a true credit due to a payor source or if additional adjustments need to be made to resolve the credit balance. This position will require working with both the payor sources and the internal team to bring resolution to the credit balance of the accounts receivable.

Key Responsibilities:

Credit Balance Resolution:

• Research and analyze patient and insurance credit balances to determine the cause and appropriate resolution.
• Process refunds and adjustments in compliance with company policies, payer guidelines, and regulatory requirements.
• Communicate with patients, insurance companies, and internal departments to clarify account discrepancies.
• Document all actions taken to resolve credit balances within the patient accounting system.

Account Reconciliation:

• Perform detailed audits of patient accounts to ensure payments, adjustments, and refunds are accurately applied.
• Identify overpayments, duplicate payments, and incorrect adjustments, and take appropriate corrective action.
• Maintain detailed records of refund requests and approvals for compliance and audit purposes.

Compliance & Reporting:

• Ensure all credit balance resolutions comply with state and federal regulations, including Medicare, Medicaid, and commercial payer policies.
• Generate and review reports to track outstanding credit balances and resolution progress.
• Assist in preparing documentation for audits and internal quality control.

Customer Service & Collaboration:

• Provide timely and professional responses to inquiries from patients, insurance companies, and internal departments regarding credit balances.
• Work closely with the billing, collections, and compliance teams to improve credit resolution processes.
• Educate team members on best practices for reducing credit balances and preventing future discrepancies.
• Additional Duties as Assigned:
• Support other revenue cycle functions as needed, including payment posting, account follow-up, or claim appeals.
• Participate in process improvement initiatives to enhance efficiency in credit balance resolution.

· Perform other administrative or financial tasks as directed by management.

• Qualifications & Skills:
• High school diploma or equivalent required; associate or bachelor’s degree in accounting, Finance, or Healthcare Administration preferred.
• 2+ years of experience in healthcare billing, accounts receivable, and inpatient revenue cycle management preferably in behavioral health. 
• Strong knowledge of insurance billing, payment posting, and credit balance resolution.
• Familiarity with payer policies, medical terminology, and regulatory guidelines (e.g., HIPAA, CMS, Medicaid, Medicare).
• Proficiency in healthcare billing systems (e.g., Epic, Cerner, Meditech) and Microsoft Office Suite.
• Excellent analytical, problem-solving, and attention-to-detail skills.
• Strong verbal and written communication skills with a customer-focused approach.
• Ability to manage multiple tasks and meet deadlines in a fast-paced environment.

Work Environment & Physical Requirements:

• Standard office environment with the ability to work remotely as needed.
• Prolonged periods of sitting and computer use.
• Occasional lifting of files or office supplies up to 10 lbs.
• Able to work during East or Central Time Zone 

Perimeter Behavioral Health is an equal opportunity employer committed to creating an inclusive workplace where all employees can thrive. We welcome applicants from all backgrounds, regardless of race, color, religion, age, sex, sexual orientation, pregnancy, gender identity, genetic information, national origin, disability status, protected veteran status, or any other characteristic protected by federal, state, or local laws.