Refund and Collections Specialist

**POSITION: Refund and Collections Specialist**

**RESPONSIBLE TO: Director of Payer Relations**

**GRADE**:$19.16 - $22.25

**SUMMARY**:
The primary functions of the
**Refund and Collections Specialist** are to manage all daily, weekly, and monthly tasks related to patient statements, patient notification of bad debt, assignment of payment plans, submission of bad debt to bad debt agencies, financial reporting of bad debt and reconciling cash payments from bad debt accounts. Additionally, this position is responsible for reviewing/approving all refund requests for processing through Refund Manager. This position is full-time, hourly, and non-exempt.

**QUALIFICATIONS**:

- To perform this job successfully, an individual must be able to perform each essential function satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

**Education/Experience**:

- At least one year of experience with third party billing, working either in a health center or administrative office environment.
- At least three years of customer service-related experience required

**Language/Communication**:

- **_ Bilingual in Spanish/English required. _**:

- Strong written and verbal communication skills.
- Strong relationship building/interpersonal skills.
- Must be able to maintain high standards of confidentiality and practice ethical communication.

**Computer Skills**:

- Knowledge of NextGen EHR billing functions and collections software; knowledge of Refund Manager a plus.
- Ability to quickly learn new technologies.
- Ability to pull reports from various systems and manipulate data as necessary.

**Other**:

- Ability to organize, prioritize, and effectively schedule work assignment
- Strong knowledge of computerized word processing/spreadsheet programs and electronic healthcare practice management systems.
- Strong knowledge of Federal, State and payer regulations regarding medical billing compliance.
- Must have excellent customer service skills and be committed to providing the highest level of customer satisfaction with staff from all parts and all levels of the organization.

**ESSENTIAL FUNCTIONS**:

- Manages the patient collections program. Handles patient complaints about fees and billing and decides upon the disposition of those complaints. Monitor and evaluate program effectiveness and progress and works with the Director of Payer Relations on improvements and changes.
- Using NextGen EDI, generates and liaises with agency in charge of patient statements.
- Submit past due balances to PPRM’s collections agencies and monitors progress. Reconciles disputes and researches patient accounts. Resolves all activities with regards to bad debt in NextGen.
- Act as a liaison with outside collection agencies and monitor their performance.
- Reviews and documents write offs of patient balances.
- Ensures that all billing and collection activities meet and adhere to Medicaid, and other insurance and state program regulations, rules and laws.
- Reviews, approves, and processes all patient and insurance refunds through Refund Manager in concert with accounting. Responsible for keeping credit balance A/R to under 2%.
- Ensuring the daily processes of collections run smoothly as well as all follow up.
- Identify performance improvement activities by monitoring tasking queues and reports.
- Collaborates with the Business Services Manager on the development and implementation of written policies and procedures to ensure efficient operations and to meet established goals and timelines.
- Collaborates with Patient Services leadership and staff to implement policies and procedures to support front office operations and facilitate access to care for patients.
- Participates in performance improvement projects as assigned.

**OTHER**
- Participates in abortion services (participation can include referrals, information, education, counseling, scheduling, etc.)
- Performs other duties as assigned.

**COVID-19 Vaccine **PPRM is joining our partners in public health across our region and county, as well as many other Planned Parenthood affiliates, by requiring that all employees are fully vaccinated. An employee is considered fully vaccinated two weeks after receiving the second dose of a two-dose vaccine (Pfizer or Moderna) or one dose of a single
- dose vaccination (Johnson and Johnson/Janssen) and all

**COVID-19**
**Booster**: PPRM staff members are required to have the COVID-19 vaccine booster shot by the first day of employment. or five months after receiving the final dose of the original vaccine series, whichever is later.

**_
Background Check Required_**

Planned Parenthood of the Rocky Mountains is an equal employment opportunity employer and is committed to maintaining a non-discriminatory work environment, and does not discriminate against any employee or applicant for employment on the basis of race, color, religion, sex, national origin, age, disabilit