Reimbursement Specialist - Healthcare jobs in Oregon

Description

Opening Date: 05/08/2024

Closing Date:   05/22/2024

Job Title: Healthcare Reimbursement Assistant

Salary/Wage: $20.45/hr.

Tribal Level 110

Location: Siletz, OR

Classification: Full Time, Non-Exempt

Job Posting Number:  2438736

INTRODUCTION:

This trainee position is to develop an entry-level applicant into a Healthcare Reimbursement Technician. When the trainee completes the required training in medical terminology, demonstrates the ability to interpret IHS/PRC regulations, policies, and operating procedures to determine eligibility using the Code of Federal Regulations (CFR) public health law.

DUTIES: 

• Receive applications for PRC assistance.  
• Collect data and verify eligibility. Maintain accurate, up-to-date PRC cuff account records and commitments.
• Assemble and mail PRC orientation packets and maintain individual patient files. Maintain pre-authorization logbook. 
• Distribute medical/dental authorizations, and type denial letters. 
• Maintain PRC general files. Audit claims for payment to ensure appropriateness of charges.  
• Identify alternate resources and make referrals as appropriate. Maintain billing and payment records.  
• Communicate with clients and providers on payment application procedures and processing steps.  
• Generate statistical data and samplings. 
• Maintain rapport with vendors. 
• Implement PRC funding priority guides, and independently approve payment of authorizations within such guides.  
• Assist clients in alternative resource application procedures.  
• Maintain adequate supplies and services required for the operation of the PRC program.  

Requirements

REQUIREMENTS:

High School diploma or GED and one year of experience in either accounts payable/receivable bookkeeping or medical billing.

This position works closely with the Healthcare Reimbursment Technician I and II in all aspects of the position duties. This position advances to a Healthcare Reimbursment Technician Iafter two –years experience and demonstrated competencey and successfully completing a medical terminology class.  

Knowledge of:

• Office procedures and a willingness to complete a medical terminology course, preferred.
• Word processing and/or ADP principles, preferred.
• The rules and regulations for Purchased/Referred Care, preferred.

Able to:

• Type, file, and use a calculator.
• Good communication and organizational skills.
• Work and communicate effectively with a wide variety of people and health agencies.