Refund Specialist - remote

Job Description

Description

PeaceHealth is seeking a Refund Specialist  for a Full Time, 1.00 FTE, Day position. The salary range for this job opening at PeaceHealth is $18.76 – $28.14. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.

***This is a remote position however, the incumbent must reside in OR, WA, AK or TX by date of hire.

Responsible for resolving requests for refunds and credit balances by conducting research, follow-up and billing activities, while remaining compliant with applicable laws, CMS regulations, and policy. This position acts as a resource to resolve questions related to patient accounts. As appropriate inputs adjustments and complies with cash related procedures and financial control.

Essential Functions

• Reviews credit balance accounts for commercial, Government and regulatory payors for proper resolution.

• Processes refund requests as appropriate.

• Researches and processes accounts for Provider Level Adjustments (PLB), apply adjustments as needed.

• Identifies payor trends associated with claim payments, patient payments and posting errors, and escalates as needed to Manager.

• Requests rebills, adjustments, corrections as needed to resolve credit balances.

• Responds punctually to patient, insurance requests and inquiries.

• Resolves work lists and other reports as assigned.

• Ensures billing compliance with state and federal laws and regulations.

• Performs other duties as assigned.

Qualifications

Education

• High School Diploma Required: or equivalent

Experience

• Minimum of 2 years Required: Experience in a medical billing, cash posting or insurance account follow-up capacity and

• Required: Formal training or college coursework from a medical coding accredited school, specific to medical billing in lieu of experience may be considered and

• Required: Experience with payer EOBs/835s and bank Lockbox processes and

• Required: Medical terminology experience

Credentials

• Preferred: HealthStream Badge and

• Preferred: Medical Billing Certificate and

• Preferred: Certified Revenue Cycle Representative

Skills

• Proficiency in use of 10-key. (Required)

• Proficient use of computers including MS Office applications. (Required)

• Knowledge of insurance and reimbursement policies. (Required)

• Strong data entry skills. (Required)

• Knowledge of basic accounting skills. (Required)

• Excellent telephone communication skills and customer service skills. (Required)

• Excellent problem-solving skills and negotiating skills. (Required)

• Ability to work under pressure and meet deadlines. (Required)

• Excellent written and verbal communication skills. (Required)

• Excellent attention to detail and ability to process and reconcile Provider Level Adjustments (PLB). (Required)

• Knowledge of banking and Lockbox processes. (Required)

• Ability to work remotely with minimal oversight, independently, as well as in a collaborative team setting. (Required)

• EPIC experience. (Preferred)

Working Conditions

Lifting

• Consistently operates computer and other office equipment.

• Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.

• Sedentary work.

Environmental Conditions

• Predominantly operates in remote environment 

Mental/Visual

• Ability to communicate and exchange accurate information.

• The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.

PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.

See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.

For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.

PeaceHealth requires a completed Primary Vaccine Series (e.g., 2 dose monovalent Pfizer, Moderna or Novavax series or 1 dose J&J vaccine series) or be Up to Date (receiving the most recent Pfizer/Moderna bivalent vaccine/booster) for COVID-19 vaccination prior to their start date. PeaceHealth has a medical and religious exemption request process for those that are unable to receive the COVID-19 primary vaccine series due to medical/religious reasons. For caregivers that will be working in Oregon there is a personal vaccine exemption form that may be requested.