Credit Balance Specialist (51435)

Job DetailsJob Location: Practice Support Center 1210 - Dallas, TX 75231Position Type: Full TimeWho We Are:

Platinum Dermatology Partners is a network of high-quality dermatology clinics that focus on collaborative and innovative ideas to drive growth. We offer general dermatology, cosmetic, medical, plastic surgery, and cancer screening treatments. We have over 145 clinics, over 350 providers, and more than 2300 employees in clinics across Texas, Arizona, California, Nevada, and Florida. We are a rapidly growing company that allows our doctors to focus on providing exceptional care without worrying about the operational side of the business. Our core values focus on collaboration, ownership, respect, excellence, authenticity, and integrity. Our purpose is to empower the practice of exceptional dermatology.

Company Conformance Statements

In the performance of their respective tasks and duties, all employees are expected to conform to the following:

Perform quality work within deadlines with or without direct supervision.
Interact professionally with other employees, customers, and suppliers.
Work effectively as a team contributor on all assignments.
Work independently while understanding the necessity for communicating and coordinating work efforts with other employees and organizations.

Position Summary: Responsible for identifying, researching, resolving, and processing credit balances within patient and insurance accounts to ensure compliance with payer contracts, government regulations, and organizational policies. This role works closely with insurance companies, patients, and other revenue cycle departments to investigate overpayments, process refunds, and maintain accurate account balances.

Principal Duties and Responsibilities

Review patient accounts with credit balances and determine the root cause of overpayments.
Investigate and resolve credit balances resulting from payer overpayments, duplicate payments, contractual adjustments, billing errors, patient payments, and other discrepancies.
Process refunds to insurance carriers, government payers, and patients in accordance with regulatory requirements and organizational policies.
Ensure timely resolution of credit balances to meet compliance standards and avoid financial penalties.
Research payer contracts, explanation of benefits (EOBs), remittance advices, and payment postings to validate account balances.
Collaborate with billing, collections, payment posting, coding, and customer service teams to resolve account discrepancies.
Maintain detailed documentation of account research, actions taken, and refund transactions.
Monitor assigned work queues and prioritize accounts based on aging and compliance requirements.
Identify trends and recurring issues contributing to credit balances and communicate findings to leadership.
Assist with internal and external audits by providing documentation and account research.
Ensure adherence to HIPAA, Medicare, Medicaid, commercial payer regulations, and organizational policies.
Meet productivity, quality, and accuracy standards established by management.

QualificationsEducation

High school diploma or GED required

Experience/Qualifications

Minimum of 1–3 years of experience in healthcare revenue cycle, medical billing, accounts receivable, payment posting, or credit balance resolution.
Experience with hospital and/or physician practice billing.
Familiarity with Medicare, Medicaid, and commercial insurance reimbursement methodologies.
Strong understanding of revenue cycle processes and payer reimbursement guidelines.
Knowledge of credit balance regulations and refund requirements.
Ability to interpret EOBs, remittance advice, payer contracts, and account histories.
Strong analytical and problem-solving skills.
Excellent attention to detail and organizational abilities.
Proficient in electronic health record (EHR) and billing systems.
Intermediate proficiency with Microsoft Excel, Word, and Outlook.
Effective written and verbal communication skills.
Ability to work independently and manage multiple priorities in a fast-paced environment.

Our competitive benefits package includes the following:

Medical, Dental, and Vision insurance
Short-term/Long-term disability
Life and other voluntary plans
401(k) plan

Employee Referral Program

Paid Time-Off

Company-Paid Holidays

Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephones, etc.

Physical Requirements: Must possess manual dexterity to operate office machines including computer and calculator; stooping and bending to handle files and supplies; and mobility to complete errands or deliveries. Includes handling of sharps and chemicals.

Equal Employment Opportunity

Platinum Dermatology Partners is committed to a policy of equal employment opportunities for applicants and Employees. Employment decisions will comply with all applicable laws prohibiting discrimination in employment, including Title VII of the Civil Rights Act of 1964, The Age Discrimination in Employment Act of 1967, the Americans with Disabilities Act of 1990, the Immigration and Nationality Act, the California Fair Employment and Housing Act, and all other applicable state and federal laws.

Platinum Dermatology Partners does not permit discrimination of any type against an employee because of any of the following legally protected characteristics: gender, race, color, religion, country of origin, mental disability, physical disability, marital status, gender identity, gender expression, ancestry, genetic information, medical condition, age, sexual orientation, or pregnancy.

Please note, that any offer of employment is contingent on the successful completion of pre-employment background checks.

No phone calls or agencies, please.