Research and Refund Supervisor

San Juan Regional Medical Center•Farmington, NM

1d•Onsite

About The Position

At San Juan Regional Medical Center, the Research and Refund Supervisor is a key team member dedicated to fulfilling the mission of making life better for the community by delivering exceptional care. This role is part of a specialized staff responsible for researching account balances and resolving credits to be refunded to individuals or insurance companies in a timely manner. The position involves providing direction to resolve credit balances and overseeing the processes to ensure timely resolution. The organization is committed to its patients and its values, which drive the provision of financial resources essential to serve the community and SJRMC. The role requires embodying SJRMC's values: Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability, and Creative Vitality, which demand a deeper level of commitment beyond just completing tasks.

Requirements

Minimum of two (2) years’ experience in healthcare insurance billing
One (1) year of supervisory experience
High School Diploma
Knowledge of the principles and practices involved in billing, credit and collection activities; laws, rules, regulations and policies affecting patient account functions
Knowledge of third-party reimbursement methodologies, primary vs secondary payor rules
Experience working in a hospital setting with insurance and posting methods
Ability to organize and coordinate work of others
Computer experience
Strong communication skills and able to speak, read and write in English
Ability to work with minimal supervision
Ability to interface ethically and professionally with all levels of management
Demonstrate ability to deliver quality work within tight deadlines
Independent decision making and discretion

Nice To Haves

Minimum of four (4) years’ experience in healthcare insurance billing
Three (3) years of supervisory experience
Knowledge of payor rules and guidelines for primary vs. secondary payor

Responsibilities

Coordinates the refund process on individual patient accounts for SJRMC and SJHP
Coordinates and approves the refunds to be sent to patients and payors
Enters refunds onto patient encounter in Cerner or Workday to be processed by Accounts Payable
Provides leadership to refund staff
Research any returned refunds for causes and update addresses to payors
Provides continual performance feedback and coaching to staff
Participates with appropriate hospital teams and projects when payments from payors are involved
Administer the lockbox, help coordinate the changes with the different payors
Responsible for Credit Balance reporting for SJRMC AND SJHP
Responsible for implementing SJRMC Service Standards into their daily work: Safety, Courtesy, Efficiency, and Stewardship