Refund Specialist for Central Admin in NE Portland

The Oregon Clinic • Portland, OR

6d • 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 work will ensure patients receive the highest value care by providing a consistent, efficient, and easy experience for patients and stakeholders. This position requires excellent customer service and communication skills.

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.
• Ability to comprehend all forms of Explanation of Benefits (Work Comp, MVA, government & commercial).
• 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: Entry Level
• Education Level: No Education Listed