Credit Balance Refund Rep

Virginia Mason Franciscan Health has a rich history of providing exceptional healthcare, dating back to 1891. Building upon a legacy of compassionate care and innovation, our organization has evolved over the years through strategic partnerships and integrations to expand our reach and services across the Puget Sound area.

Today, as Virginia Mason Franciscan Health, we remain deeply committed to healing the whole person – body, mind, and spirit – in the communities we serve. This commitment is strengthened by the diverse expertise and shared values brought together through our growth.

Our dedicated providers offer a full spectrum of health care services, from routine wellness to complex disease management, all grounded in rigorous research and education. Our comprehensive network of 10 hospitals and nearly 300 care sites strategically located across the greater Puget Sound region reflects our ongoing commitment to accessibility and comprehensive care.

We are proud of our pioneering medical advances and numerous awards and accreditations that reflect our dedication to excellence. When you join Virginia Mason Franciscan Health, you become part of a team that delivers top-quality, professional healthcare in modern, well-equipped facilities, and contributes to a legacy of service built on collaboration and shared purpose.

As a Credit Balance Refund Representative, you will resolve insurance and patient credit balances, issuing and requesting refunds to ensure patient satisfaction and regulatory compliance.

Every day you will ensure timely and accurate resolution of all credit balance accounts, identifying if refunds, payment transfers, or adjustments are needed through thorough account research.

To be successful in this role, you will apply your understanding of billing requirements and insurance follow-up practices, demonstrating attention to detail and efficient problem-solving for refund issues.

• Reviews and analyzes accounts and/or reports from insurance companies and patients to facilitate the resolution of credit balance accounts.
• Reviews accounts and/or reports, including: Explanation of Benefits (EOB)/ Electronic Remittance Advice (ERAs), payments, adjustments, insurance contracts and contracting system, insurance benefits, and all account comments; contacts and communicates with insurance companies to gather additional information, as necessary.
• Refunds overpayments on accounts and transfers payments to the appropriate accounts.
• Verifies all patient account charges are billed to the insurance plan.
• Validates that insurance has paid correctly and identifies any patient responsibility.
• Conducts appropriate review to accurately transfer payments in accordance with established procedures.

Required

• Two years of revenue cycle or related work experience that demonstrates attainment of the requisite job knowledge and abilities or
• Other Post-high school education in a field (e.g. medical billing) that would demonstrate attainment of the requisite job knowledge/abilities may be substituted.