Payment & Refund Specialist I

Located in the heart of Washington, we enjoy open skies, snow-capped mountains, and the lakes and rivers of the high desert. We are the proud home of orchards, farms, and small communities. Confluence Health actively supports the communities we serve and their quality of life through our community support program and through our individual efforts as involved community members.

Full Time Employees of Confluence Health receive a wide range of benefits in addition to compensation.

• Medical, Dental & Vision Insurance
• Flexible Spending Accounts & Health Saving Accounts
• Paid Time Off
• Generous Retirement Plans
• Life Insurance
• Long-Term Disability
• Gym Membership Discount
• Tuition Reimbursement
• Employee Assistance Program
• Adoption Assistance
• Shift Differential

For more information on our Benefits & Perks, click here!

To process and post accurate and timely refunds and payments.

Position Reports To: Business Office Manager

1. Opens daily mail, sort and batch payments.

2. Scan EOB’s and refund letters.

3. Process payments and adjustments accurately and timely for electronically and hand posting.

4. Process daily remote deposits and log sheets of wire deposits.

5. Process refunds accurately and timely for payors and patients.

6. Verify insurance and update coverage within 24 hours of receipt.

7. Respond to audit requests and payer inquiries within required timeframes.

8. Accurately work assigned work queues and document appropriately.

9. Accurately process corrections and void transactions per policy.

10. Maintain knowledge of payer rules, CMS regulations, and hospital and professional billing guidelines.

11. Assist with additional revenue cycle duties as assigned.

12. Collaborate with internal departments, providers, and payers to resolve complex payment and refund issues.

13. Performs other duties as assigned.

Demonstrate Standards of Behavior and adhere to the Code of Conduct in all aspects of job performance at all times.

Required:

• High School Diploma or equivalent.

• AAHAM, HFMA, AHIMA, AAPC, AHCC, NAHAM or Code ProU certification OR 1 year Revenue Cycle experience; payment posting, refunds, scheduling, patient access, authorizations, coding and or charge capture.
• Proficient in basic math.

• Strong attention to detail.

• Basic computer skills.

• Strong organizational and communication skills.

O = Occasional, represents 1 to 25% or up to 30 minutes in a 2 hour workday.
F = Frequent, represents 26 to 50% or up to 1 hour of a 2 hour workday.
C = Continuous, represents 51% to 100% or up to 2 hours of a 2 hour workday.

Physical/Sensory Demands For This Position:

• Walking – O
• Sitting/Standing - C
• Reaching: Shoulder Height - F
• Reaching: Above shoulder height - F
• Reaching: Below shoulder height - F
• Climbing - O
• Pulling/Pushing: 25 pounds or less - O
• Pulling/Pushing: 25 pounds to 50 pounds - O
• Pulling/Pushing: Over 50 pounds - O
• Lifting: 25 pounds or less - O
• Lifting: 25 pounds to 50 pounds - O
• Lifting: Over 50 pounds - O
• Carrying: 25 pounds or less - O
• Carrying: 25 pounds to 50 pounds - O
• Carrying: Over 50 pounds - O
• Crawling/Kneeling - O
• Bending/Stooping/Crouching - O
• Twisting/Turning - F
• Repetitive Movement - F

Working Conditions:

• Normal office environment which consists of sitting at a desk for long periods of time, talking on the telephone, working on computers and paperwork. This environment also consists of working in close proximity to co-workers, working under deadlines and achieving productivity standards.

Job Classification:

• FLSA: Non-exempt
• Hourly/Salary: Hourly

Physical Exposures For This Position:

• Unprotected Heights – No
• Heat – No
• Cold – No
• Mechanical Hazards – No
• Hazardous Substances – No
• Blood Borne Pathogens Exposure Potential – No
• Lighting – No
• Noise – No
• Ionizing/Non-Ionizing Radiation – No
• Infectious Diseases – No