Research and Refund Supervisor

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.RequiredBehaviors: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.RequiredQualifications:Minimum of two (2) years’ experience in healthcare insurance billingOne (1) year of supervisory experienceHigh School DiplomaKnowledge of the principles and practices involved in billing, credit and collection activities; laws, rules, regulations and policies affecting patient account functionsKnowledge of third-party reimbursement methodologies, primary vs secondary payor rulesExperience working in a hospital setting with insurance and posting methodsAbility to organize and coordinate work of othersComputer experienceStrong communication skills and able to speak, read and write in EnglishAbility to work with minimal supervisionAbility to interface ethically and professionally with all levels of managementDemonstrate ability to deliver quality work within tight deadlines Independent decision making and discretionPreferredQualifications:Minimum of four (4) years’ experience in healthcare insurance billingThree (3) years of supervisory experienceKnowledge of payor rules and guidelines for primary vs. secondary payorDuties and Responsibilities:Coordinates the refund process on individual patient accounts for SJRMC and SJHPCoordinates and approves the refunds to be sent to patients and payorsEnters refunds onto patient encounter in Cerner or Workday to be processed by Accounts PayableProvides leadership to refund staffResearch any returned refunds for causes and update addresses to payorsProvides continual performance feedback and coaching to staffParticipates with appropriate hospital teams and projects when payments from payors are involvedAdminister the lockbox, help coordinate the changes with the different payorsResponsible for Credit Balance reporting for SJRMC AND SJHPResponsible for implementing SJRMC Service Standards into their daily work: Safety, Courtesy, Efficiency, and StewardshipPhysical Demands and Environmental Work Conditions:Extended SittingExtended reading/ research on computerExtended listeningExtensive 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) poundsWork Environment:The typical noise level will vary from quiet to very loudOccasional mild variance in room temperatureSensory Requirements:The employee will need adequate ability to:See both close and distant objectsAdjust visual focusThe employee will need adequate ability to:Hear human speech, primarily telephone communicationHear verbal instructions