Creating Life Better Here starts with you. At San Juan Regional Medical Center, we're more than a healthcare provider—we're a values-driven organization dedicated to delivering exceptional care. As a team member, you help fulfill our mission to make life better here for our community.
To be a part of a team of specialized staff in researching account balances and resolving a credit to be refunded to an individual or insurance company in a timely manner. We are committed to our patients and our values drive us to provide the financial resources essential to serve our community and SJRMC by providing direction to resolving our credit balances. Overseeing the processes involved in resolving credit balances in a timely manner.
Required Behaviors:
- As you go about fulfilling this mission, your work habits and work relationships should embody SJRMC's values. These values are our culture, our identity as an organization. Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability and Creative Vitality ask more of us than merely completing some list of tasks. Our values ask for a deeper level of commitment, and what is asked of us we freely give because we believe in our mission.
Required Qualifications:
- 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
Preferred Qualifications:
- 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
Duties and 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
Physical Demands and Environmental Work Conditions:
- Extended Sitting
- Extended reading/ research on computer
- Extended listening
- Extensive repetitive motions of both hands, such as wrist/hand movements, grasping, finger dexterity (i.e., typing, writing, faxing, filing, etc.)
- Ability to lift up to fifty (50) pounds
Work Environment:
- The typical noise level will vary from quiet to very loud
- Occasional mild variance in room temperature
Sensory Requirements:
The employee will need adequate ability to:
- See both close and distant objects
- Adjust visual focus
The employee will need adequate ability to:
- Hear human speech, primarily telephone communication
- Hear verbal instructions