Refund and Credit Balance Specialist
University of California, San Francisco · Emeryville
The Refund and Credit Balance Specialist also known as our Senior Government Credit Balance Specialist (SGCBS), is responsible for resolving accounts with credit balances. These include credits associated with audit findings and overpayments/overadjustments by payors and patients. Additionally, the SGCBS reviews requests for refunds from payors and coordinates the rebilling process to the primary payor following departmental guidelines. The SGCBS is also responsible for the following but not limited to:
- Collections of accounts refunded by the Medical Center and payment retractions generated by the payor.
- Reviewing external auditor refund requests for management approval
- Resolving credits by meeting payor quarterly/annual credit balance report requirements and;
- Cancelling or adjusting previous claims submissions.
The SGCBS utilizes multiple databases and applications to analyze and take appropriate action on information or documents received. Applications and Databases consist of EPIC, Hospital Rates, CIRIUS, RevCyclePro, Imaging, Refund Database, DDE and various payer websites. Frequent contact with Patient Financial Services staff, departments and management, as well as patients, billing and professional fee and collection services vendors.
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