Reimbursement Specialist - Healthcare jobs in San Bernardino, CA

SUMMARY: 

Under general supervision of Administrative Unit Manager - Purchase of Service perform fiscal clerical work in connection with the examination, calculation, reconciliation and recording of accounts payable records, verify check claims for payment, process requests to authorize payments; verify records for accuracy and completeness; and prepare summary reports. Perform related work as required.

HOURLY RANGE:

• $23.1037 - $32.5092 per hour 

SIGN-ON BONUS!

• $250 sign-on bonus after the completion of 90 days of employment at IRC with work performance in good standing.
• $500 sign-on bonus after the completion of 6 months of employment at IRC with work performance in good standing.
• Make sure to tell us if an IRC employee referred you when you get to that question on your application! Please include their full name.

GENEROUS BENEFITS PACKAGE AND EMPLOYEE PERKS:

• To view our benefits package and employee perks, please click HERE . 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Examine vendor paper and electronic invoices daily for accuracy and completeness.
• Prepare, verify changes and key enter accounts payable (A/P) input within scheduled time frames.
• Accurately calculate payment from vendorized rates, Schedule of Maximum Allowance (SMA), Current Procedural Terminology (CPT) or negotiated rate, and/or bill for third party payments, proportionate cost, and absences. Substantiate amount, source, and distribution of consumer revenue.
• Investigate on-line edits, warning, errors and resolve according to agency procedures/policy.
• Key enters payment data to generate checks. Prepare and mail checks. Post and record financial transactions. Print invoice screen indicating potential loan; verify validity with Revenue Consumer Unit (RCU) and confer with manager on course of action.
• Receive and examine service authorization requests weekly for compliant approval level, validity of services, and completion of required information e.g. license, insurance, cardiopulmonary resuscitation CPR. 
• Verify level of supervision with rate tools; verify source of fund (SOF) information, payee status, and ensure SOF amounts cover basic cost of care. Record and bill third party payors as assigned.
• Investigate and resolve discrepancies between service request and vendor, consumer or SOF information.
• Examine and process authorization requests within 15 calendar days of receipt daily. Select correct rate subcode, service type, service code, and authorization setup.
• Indicate special processing requirements. Notify staff or public of missing or incomplete documents and/or logs and return unacceptable documents within one day of receipt. 
• Confirm monthly consumer benefit expected or currently being received by consumer.
• Key enters data to generate accurate authorization on a timely basis. Type request data card as required.  Post and record financial transactions. 
• Encumber/disencumber funds and modify authorization setup based on new or changed authorizations, rates, payments, or terminations.
• Request edit reports and reconcile input document with edit, make correcting entries as needed and verify control totals.
• Prepare and mail authorization and invoice documents at scheduled times.
• Post encumbrances from authorization entry.
• Process release of conserved consumer funds (ICRC 106) according to established time frames.
• Examine request for validity and disbursement approval.
• Set pay date according to established pay schedule.
• Create and edit pay batch for entry and/or address errors.
• Investigate ICRC 106's rejected due to insufficient funds.
• Notify RCU promptly when unable to process because of insufficient funds. Correct and reenter when applicable.
• Serve as resource to agency staff and service vendors daily. Assist employees in finding information or materials as assigned. Handle complaints and resolve discrepancies in payments and authorizations. Explain billing requirements and assist vendors in following procedures for billing and payment on a timely basis. Explain or interpret billing unit policy and procedures to employees, public or officials. 
• Maintain log and verify number of checks issued. Identify, stamp and void checks by making adjusting entries to fiscal records and complete required documents.
• Distribute checks, payment register, certification statements, authorization tickler and other appropriate documents on schedule.
• Compile monthly and periodic reports such as summaries of projected encumbrances by budget code, category, and fiscal year.
• Compose and type correspondence to vendors to recover overpayments and about services not authorized.
• Send standard letter in response to routine request. Send standard letter requesting invoice or notice that services were not provided. 
• Assist manager in documenting procedures and writing instructions. Develop, adapt, or select most appropriate procedure to carry out directives. 
• On a daily basis maintain an adequate skill level in interpersonal and community relationships.
• Comply with agency Personnel Policies and Procedures, and Affirmative Action Plan.
• Maintain good attendance and punctuality.
• Key enters data into IBM AS400.
• Prepare and distribute necessary reports on a timely basis.
• Keep manager informed of pending work, work in progress and problems encountered.
• Update knowledge through reading, briefings, and training.
• Drive vehicle/travel to other offices/locations to pick up, deliver materials.
• Organize travel effectively and efficiently. Maintain a safe driving record.
• Utilize agency’s IT systems as assigned, maintain security and following agency’s protocol and procedures, rules, and requirements. Use equipment appropriately and keep it in good repair. Keep work area neat and orderly.  Observe all safety rules.
• Comply with the administrative requirements of the agency on a daily basis. Work cooperatively and effectively with others. Perform as a member of the team, answer questions, share expertise and contribute to the harmony of the team. Handle change well and be flexible and adaptable in dealing with interruptions, new priorities, and new assignments.
• As needed or assigned, screen and distribute incoming unit mail.
• Perform different or additional work as needed or assigned. Perform unit assignments on rotation basis or as assigned.

MINIMUM POSITION REQUIREMENTS:

• High school diploma or equivalent. Twenty-four (24) months of clerical accounting work to include 18 months A/P and one year heavy key entry and EDP file maintenance. A Bachelor’s degree in Business or Accounting may be considered in lieu of work experience. 
• Knowledge of bookkeeping and accounting terminology practices and procedures.
• Knowledge of office practices and procedures.
• Knowledge of electronic data processing as it relates to accounting.
• Ability to reconcile differences within the record keeping system requiring an understanding of the relationships among accounting records and documents.
• Ability to maintain ledgers and to prepare statistical summaries and reports.
• Ability to use ten key/calculator proficiently.
• Ability to read and interpret governmental regulations. Ability to establish and maintain effective working relationships with others. Ability to work cooperatively and effectively with others. Perform as a member of a team, answering questions, sharing expertise, and generally contributing to the harmony of the team.
• Ability to handle change well and be flexible and adaptable in dealing with interruptions, new priorities, and new assignments. Ability to follow oral and written direction. Good verbal and written communication skills.
• Demonstrate ability to type accurately 35 wpm.
• Assure that consumer rights and dignity are maintained in the provision of services.
• Full use of an automobile, possession of a valid California driver's license and liability insurance for the minimum amount prescribed by law or ability to provide for independent transportation. Must have and maintain a safe driving record.

We are proud to be an EEO employer. We maintain a drug-free workplace and perform pre-employment substance abuse testing.