Refund Specialist for Central Admin in NE Portland

The Oregon Clinic • Portland, OR

1d • Hybrid

About The Position

Join The Oregon Clinic as a full-time Refund Specialist in our Central Administration office. This role offers a hybrid/remote work arrangement after initial training. You will be part of a collaborative team focused on delivering world-class care with kindness and empathy. Your primary function is to ensure patients receive the highest value care by providing a consistent, efficient, and easy experience for patients and stakeholders. This involves researching refund requests, overpayments, and credit balances, ensuring accurate application of funds and timely refunds to the appropriate parties. You will also resolve credit balances on accounts receivable in accordance with policy, review adjustments, and assemble documentation to validate credits. Additionally, you will return incorrect payments to payors, resolve unclaimed property, and communicate with insurance carriers/guarantors regarding discrepancies and unidentified payments. Other duties may be assigned.

Requirements

• Minimum of three (3) years of experience in medical accounts receivable or payment posting.
• Knowledge of medical insurance billing, COB, HCFA 1500's, and State and Federal medical insurance processing rules.
• Demonstrated ability to initiate, work independently, and effectively multitask.
• Positive attitude and desire to be a team player.
• Ability to communicate professionally and effectively with patients, physicians, and other team members.
• A commitment to patient-focused care, privacy, and safety.

Nice To Haves

• Prior experience working in Medicare and Medicaid claims is a plus!
• Prior Electronic Medical Record (EMR) EPIC experience is strongly preferred.

Responsibilities

• Manages a variety of tasks, researching refund requests, overpayments, and credit balances, and ensuring money is correctly applied and overpayments are refunded to the appropriate party.
• Researches and resolves credit balances on accounts receivable.
• Resolves credit balances in accordance with current policy and procedures.
• Reviews all adjustments and assembles necessary documentation to validate credit balance.
• Resolves and returns incorrect payment to payor.
• Resolves unclaimed property aged over six months and clears accounts monthly.
• Contacts insurance carriers/guarantors as necessary on credit balance discrepancies, offsets, mail correspondence, and unidentified payments.
• Other duties as assigned.

Benefits

• Employee is 100% covered Medical, Dental, and Prescription Insurance
• Generous 401(k) plan
• Flexible Spending Account options
• Paid Time Off
• 9 paid holidays annually
• Robust wellness program
• Employee assistance services
• 70% of Tri-Met transit pass covered
• Employee discounts
• Optional benefits like Pet Insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed