At Tactile Medical, we specialize in developing at-home therapy devices to treat lymphedema, chronic venous insufficiency and respiratory illnesses.
The Accounts Receivable Credit Specialist is responsible for reviewing and resolving insurance credit balances to ensure accurate account reconciliation and regulatory compliance. This role analyzes credit balances to determine appropriate resolutions, including refunds, transfers, adjustments, or contractual allowance corrections. The specialist identifies trends, investigates root causes, and collaborates with cross-functional teams to reduce future credit balances and improve operational efficiency.
Key Responsibilities
- Review, investigate, and resolve insurance credit balances in a timely and accurate manner.
- Research claim payment discrepancies and determine appropriate corrective actions, including rebilling, adjustments, transfers, or refunds.
- Initiate and process identified overpayment refunds in accordance with company policies and payer requirements.
- Prepare and submit refund requests for approval and maintain supporting documentation.
- Manage payer refund disputes and appeals related to inappropriate refund requests.
- Collaborate with the Contracting team, Cash Application team, and other stakeholders to identify and implement necessary posting corrections.
- Determine and execute the appropriate resolution for credit balance inquiries and refund requests.
- Analyze credit balance activity to identify trends, recurring issues, and root causes.
- Report payer processing issues and partner with internal teams to develop corrective action plans.
- Process and respond to payer correspondence related to credit balances, refunds, and account adjustments.
- Ensure compliance with payer contracts, government regulations, and company policies.
- Participate in process improvement initiatives aimed at reducing credit balances and improving reimbursement accuracy.
- Perform additional duties and special projects as assigned.
Education & Experience
Required:
- Bachelor’s degree in business, Healthcare Administration, Finance, Accounting, or a related field preferred; equivalent combination of education and experience will be considered.
- Minimum of five (5) years of healthcare revenue cycle experience, with a focus on accounts receivable, collections, refunds, or credit balance resolution.
- Strong knowledge of commercial and government insurance programs, including Medicare and Medicaid.
- Durable Medical Equipment (DME) experience.
Preferred:
- Experience with Brightree DME software.
Knowledge, Skills & Abilities:
- Proficient in Microsoft Office Suite, including Excel, Word, and Outlook.
- Strong analytical, critical thinking, and problem-solving skills.
- Ability to independently research and resolve complex account issues.
- Strong attention to detail with a high degree of accuracy.
- Excellent organizational and time management skills with the ability to prioritize multiple responsibilities.
- Ability to thrive in a fast-paced, dynamic, and growth-oriented environment.
- Demonstrated accountability and ownership of assigned responsibilities.
- Strong interpersonal, written, and verbal communication skills.
- Ability to collaborate effectively across departments and with all levels of the organization.
- Knowledge of insurance payment processing, denials, adjustments, and reimbursement practices.
- Results-oriented with a strong sense of urgency and commitment to meeting deadlines.
- Ability to work independently with minimal supervision while exercising sound judgment.
Core Competencies
- Change Agility
- Integrity and Trust
- Communication
- Influencing and Collaboration
- Planning and Organization
- Data Analysis and Reporting
- Priority Setting
- Problem Solving
- Accountability
Success Measures
- Timely resolution of assigned credit balances.
- Accuracy and compliance of refund processing.
- Identification and reduction of recurring credit balance issues.
- Effective collaboration with internal departments and external payers.
- Achievement of productivity and quality goals established by leadership.
Our total compensation package includes medical, dental and vision benefits, retirement benefits, employee stock purchase plan, paid time off, parental leave, family medical leave, volunteer time off and additional leave programs, life insurance, disability coverage, and other life and work wellness benefits and discounts. Benefits may be subject to generally applicable eligibility, waiting period, contributions, and other requirements and conditions.
Below is the starting salary or hourly range for this position, although offers may differ based on the candidate's location, job-specific knowledge, skills and experience.
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Skills Required
- Bachelor’s degree in business, Healthcare Administration, Finance, Accounting, or a related field; equivalent education and experience may be considered.
- At least five years of healthcare revenue cycle experience focused on accounts receivable, collections, refunds, or credit balance resolution.
- Strong knowledge of commercial and government insurance programs, including Medicare and Medicaid.
- Durable Medical Equipment experience.
- Experience with Brightree DME software.
- Proficiency in Microsoft Office Suite, including Excel, Word, and Outlook.
- Knowledge of insurance payment processing, denials, adjustments, and reimbursement practices.
What We Do
Tactile Medical is one of the fastest growing companies in medical devices. As a leader in treatment options for lymphedema and venous ulcer therapies, Tactile Medical develops advanced home therapy devices to improve health and quality of life for patients with chronic swelling . Headquartered in Minneapolis, Minnesota, we advocate for patient access and serve tens of thousands of patients through a direct national network of product specialists and trainers, reimbursement experts, patient advocates, and clinical staff.
