Career Opportunities with TriCore Reference Laboratories
A great place to work.
Career Opportunities with TriCore Reference Laboratories
A great place to work.
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| Department: | RGI Revenue Operations |
| Location: | Albuquerque, NM |
Scheduled Shift: Monday-Friday 8:00am to 5:00pm with holidays and other shifts as needed.
Location: Business Office
JOB SUMMARY:
Responsible for the research and analysis of all patient account credit balances to determine appropriate resolution, research and entry of submitted debit/credit adjustments from department (i.e. bad debt, test adjustments) and processing of refunds in a timely manner and with a high degree of accuracy. Must meet daily goal of entering adjustments within 24 hours of receipt. Ability to analyze and identify trends in collection problems. Exercises independent judgment, selfmotivation, and problem solving abilities in performing all assigned duties. Posses the ability to direct the work of other employees within the team in the absence of Supervisor or Lead.
ESSENTIAL FUNCTIONS:
1. Perform patient account adjustments received from department within 24 hours of receipt.
2. Research credit/debit balances with a high degree of accuracy.
3. Processes identified refunds, as necessary, to insurance companies or patients in a timely manner.
4. Analyze and research trends in credit balances and adjustments; communicates results back to upper management.
5. Contact insurance companies, employers, etc, by telephone to resolve payment issues as needed. Utilize on-line insurance resources to obtain and maintain current information.
6. Completes the After-network report.
7. Record comments in patient account notes according to Business Office Department polices, procedure and or/practice.
8. Communicate effectively and professionally to all customers (internal and external).
9. Conduct training for other staff members as directed.
MINIMUM EDUCATION:
• High school diploma or equivalent.
MINIMUM EXPERIENCE:
Must meet one of the following:
• At least Six (6) months as an Adjustment Specialist Apprentice in the Business Office at TriCore.
• Two (2) to three (3) years relevant experience in the TriCore Business office (i.e. as a Claims Specialist I or Payment Posting Specialist)
• Three (3) to six (6) years relevant medical collections experience.
OTHER REQUIREMENTS:
• 10 key at 7000 keystrokes per hour. • Type 35 words per minute.
• Knowledge of patient accounting information systems.
PREFERENCES:
CPT and ICD-9 coding.
Experience in working refunds in a medical environment.
