<p style="text-align:left"><span>SHIFT:</span></p>Day (United States of America)<p style="text-align:inherit"></p><p style="text-align:inherit"></p><p><b>Seeking Breakthrough Makers</b><br><br>Children’s Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation.<br><br>At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care—and your career.<br><br><br>CHOP does not discriminate on the basis of race, color, sex, national origin, religion, or any other legally protected categories in any employment, training, or vendor decisions or programs. CHOP recognizes the critical importance of a workforce rich in varied backgrounds and experiences and engages in ongoing efforts to achieve that through equally varied and non-discriminatory means.<br><br><br><b>A Brief Overview</b></p><p></p><p><b><span>Master Account Accuracy. Resolve Complex Problems. Enjoy True Work–Life Balance.</span></b></p><p></p><p><span>Join a team where your attention to detail and operational expertise directly support financial accuracy and organizational integrity.  In this role, you’ll work hands‑on in production work queues to resolve credit balances, correct account discrepancies, and ensure clean, compliant financial outcomes.  And with a culture that truly values work–life balance, you’ll have the flexibility, support, and space you need to thrive.</span></p><p><span> </span></p><p><span>We’re seeking a Credit Resolution Analyst for our Professional Billing (PB) teams to help maintain financial accuracy, compliance, and operational excellence.  This position offers<span> </span><b>80% remote work</b>, giving you flexibility without sacrificing meaningful, impactful work.</span></p><p><span> </span></p><p></p><p><b><span>As a Credit Resolution Analyst, you will:</span></b></p><ul><li><span>Work daily in PB credit resolution work queues to investigate and resolve credit balances and account discrepancies.</span></li><li><span>Review payments, adjustments, denials, and transactional activity to ensure accurate account outcomes.</span></li><li><span>Identify root causes of recurring credit issues and escalate patterns or systemic concerns to leadership.</span></li><li><span>Maintain strong internal controls and support special projects that enhance data quality, reduce errors, and improve operational efficiency.</span></li><li><span>Serve as a knowledgeable resource for PB credit workflows and resolution standards.</span></li></ul><p></p><p><b><span>What You Bring</span></b></p><p></p><p><span>The ideal candidate:</span></p><ul><li><span>Has experience with PB credit resolution, account corrections, or revenue cycle operations.</span></li><li><span>Excels at researching complex account issues and determining accurate resolution steps.</span></li><li><span>Thrives in a production environment requiring independent problem‑solving and sound decision‑making.</span></li><li><span><span><span><span> </span></span></span></span><span>Manages multiple requests and deadlines while maintaining accuracy and compliance.</span></li><li><span>Communicates clearly and collaborates effectively with internal teams (no direct customer service responsibilities).</span></li><li><span><span><span><span> </span></span></span></span><span>Is committed to improving processes, identifying trends, and supporting continuous quality improvement.</span></li></ul><p></p><p></p><p><b><span>Why You’ll Love This Role</span></b></p><ul><li><b><span>80% Remote</span></b><span><span> </span>– Enjoy flexibility while staying connected to a supportive team.</span></li><li><b><span>High‑Impact Work</span></b><span><span> </span>– The accounts you resolve today ensure cleaner financials tomorrow.</span></li><li><b><span>Collaborative Culture</span></b><span><span> </span>– Work with knowledgeable professionals who value accuracy and operational excellence.</span></li><li><b><span>Growth Opportunity</span></b><span><span> </span>– Strengthen your technical skills and deepen your understanding of PB revenue cycle operations.</span></li></ul><p><br><br><b>What you will do</b></p><h3></h3><h3></h3><h3>Credit Balance Review & Root Cause Analysis</h3><ul><li><p>Review individual credit accounts housed within Epic credit work queues and daily credit balance reports to determine the root cause of the credit balance</p></li><li><p>Duties are dedicated to accuracy, timely review, and analysis of any elements mapped to credit balances through root cause analysis</p></li><li><p>Responsible to identify trends and the root cause for credits; collaborates with the appropriate parties to minimize refunds</p></li></ul><h3></h3><h3>Account Reconciliation & Payment Accuracy</h3><ul><li><p>Review all aspects of account transactions including reimbursement (expected vs. actual) and the posting of the payments/adjustments to the billing system to ensure congruence with payer contracts</p></li><li><p>Ensure credits are reviewed and resolved in a timely manner, taking the appropriate action for resolution, including issuing refunds</p></li><li><p>Handle all system updates/process to ensure that the account is appropriately documented</p></li></ul><h3></h3><h3>Payer Contracts, Billing Rules & Appeals</h3><ul><li><p>Clear understanding of third-party contract language; appeals process management; medical billing regulations-guidelines, payor specific rules and guidelines, and financial accounts receivable language</p></li><li><p>Retain extensive knowledge of fee schedules, contracts and multiple claim payment systems in order to facilitate the credit balance resolution process</p></li></ul><h3></h3><h3>Analytics, Reporting & Continuous Improvement</h3><ul><li><p>Excellent oral and written communication skills with strong analytical skills as well as report writing and data mining/extraction</p></li><li><p>Suggests ideas and solutions for performance and quality improvement and provides feedback to team leaders</p></li></ul><h3></h3><h3>Revenue Cycle Operations Knowledge</h3><ul><li><p>Responsible for full comprehension of CHOP revenue cycle work design including registration, billing, payment posting, account receivable follow-up, and compliance actions</p></li></ul><h3></h3><h3>Training, Collaboration & Professional Conduct</h3><ul><li><p>Demonstrates quality and effectiveness in work habits in every interaction with colleagues and leadership</p></li><li><p>Provides training as assigned to new employees, as well as cross training</p></li><li><p>Interfaces well with all levels of staff and management</p></li><li><p>Meets established daily/weekly reasonable work expectation of productivity and quality requirements</p></li></ul><h3></h3><h3>Compliance, Privacy & Safety</h3><ul><li><p>Maintains all PHI in accordance with HIPAA, JACHO, third party contractual agreements along with CHOP policy and procedures</p></li><li><p>Consistently supports compliance by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state, and local laws and regulations</p></li><li><p>Reports safety hazards, accidents and incidents, and unsafe working conditions promptly</p></li></ul><h3></h3><h3>Organizational Values & Culture</h3><ul><li><p>Demonstrates behaviors that are consistent with CHOP’s organizational values of Integrity, Compassion, Accountability, Respect and Excellence (ICARE)</p></li><li><p>Ensures work is performed, relationships are built, responsibility is assumed, and service delivered expresses the CHOP’s values through action</p></li></ul><h3></h3><h3>Cross-Functional Collaboration & Operational Efficiency</h3><ul><li><p>Ability to communicate effectively and collaborate with teams across Patient Financial Services and other departments around operational efficiencies</p></li><li><p>Provide recommendations for corrective action to management team to ensure efficiency of the revenue cycle</p></li></ul><h3></h3><h3>Additional Responsibilities</h3><ul><li><p>Other duties as assigned within the scope of the responsibilities</p></li></ul><p></p><p></p><p><b>Education Qualifications</b></p><ul><li>High School Diploma / GED - Required</li><li>Bachelor's Degree - Preferred</li></ul><p></p><p></p><p><b>Experience Qualifications</b></p><ul><li>At least two (2) years experience in billing, payment posting, operations, or related role - Required</li><li>At least three (3) years experience in billing, payment posting, operations, or related role - Preferred</li><li>Experience with Epic systems Preferred</li></ul><p></p><p><b>Skills and Abilities</b></p><ul><li>HIPAA compliance standards (Required proficiency)</li><li>Effective communication, interpersonal skills, analytical skills, and problem solving skills. (Required proficiency)</li><li>Demonstrated customer service skills, customer focus abilities and the ability to understand Children’s Hospital of Philadelphia customer needs. (Required proficiency)</li><li>Must maintain high-level knowledge of claim submission requirements. (Required proficiency)</li><li>Ability to work cooperatively in a team environment. (Required proficiency)</li><li>Demonstrated effective interpersonal, verbal, and written communication skills. (Required proficiency)</li><li>Knowledge of Microsoft Office applications including Word, Excel. (Required proficiency)</li><li>Excellent organizational and time management skills. (Required proficiency)</li><li>Must have 10-key by touch. (Required proficiency)</li><li>Demonstrated experience with multiple computer applications. (Required proficiency)</li><li>Experience in using commonly used electronic health records and healthcare revenue cycle financial management systems. (Required proficiency)</li><li>Detail and results oriented. (Required proficiency)</li><li>High aptitude for math. (Required proficiency)</li><li>Excellent writing and oral communication skills. (Required proficiency)</li><li>Ability to work independently and prioritize work. (Required proficiency)</li><li>Basic Computer skills (Required proficiency)</li><li>High proficiency in Microsoft Excel. (Required proficiency)</li><li>Knowledge of third-party reimbursement and physician/hospital billing. (Preferred proficiency)</li><li>Experience in using commonly used electronic health records and healthcare revenue cycle financial management systems. (Preferred proficiency)</li></ul><p><br><b>To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must receive an annual influenza vaccine. <a href="https://careers.chop.edu/us/en/how-we-hire" target="_blank">Learn more.</a><br><br><a href="https://careers.chop.edu/us/en/eeo" target="_blank">EEO / VEVRAA Federal Contractor</a> | <a href="https://careers.chop.edu/us/en/tobacco-statement" target="_blank"> Tobacco Statement </a></b></p><p style="text-align:inherit"></p><p style="text-align:left"><b>SALARY RANGE:</b></p><p style="text-align:inherit"></p>$27.35 - $34.19 Hourly<p style="text-align:inherit"></p><p style="text-align:left">Salary ranges are shown for full-time jobs. If you're working part-time, your pay will be adjusted accordingly.</p><p style="text-align:inherit"></p><p style="text-align:inherit">-------------------</p><p style="text-align:inherit"></p><p style="text-align:left">At CHOP, we are committed to fair and transparent pay practices. Factors such as skills and experience could result in an offer above the salary range noted in this job posting. Click <a href="https://careers.chop.edu/us/en/benefits" target="_blank"><span><u><span>here</span></u></span></a> for more information regarding CHOP's Compensation and Benefits.</p>