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Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope's growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. Our dedicated and compassionate employees are driven by a common mission: To deliver the cures of tomorrow to the people who need them today.

This role efficiently resolves credit balances by thoroughly analyzing, calculating and identifying true refunds.

As a successful candidate, you will:

• Review and analyze insurance and patient refund requests received.

• Able to calculate expected reimbursement based on payor contracts and assess true overpayments.

• Prepares all necessary documentation to support the refund requests.

• Ensures that all approved refunds are logged and reconciled with the Finance Department.

• Post all approved refunds in the patient ledger.

• Responds timely and accurately to all incoming related refund calls and correspondence inquiries from payers, patients and other authorized parties.

• Maintains the undistributed account balance to minimum dollar threshold as required per department policies.

• Organizational Expectations:

  • Demonstrates behavior that supports the City of Hope Medical Foundation's mission.

  • Attends required orientation and training seminars.

  • Meets production standards within established time requirements.

  • Work product and performance meets quality standards.

  • Demonstrates respect and positive interpersonal skills with patients, clients, the public, managers, and co-workers-a team player.

  • Maintains confidentiality of patient care and business matters.

  • Observes time, attendance, and dress code standards.

  • Protects the safety of others and of the physical plant and equipment, following institution policies, fire, safety and infection control regulations.

  • Follows established City of Hope and department policies, procedures, objectives, performance improvement, attendance, safety, environmental, and infection control guidelines, including adherence to the workplace Code of Conduct and Compliance Plan.

  • Practices a high level of integrity and honesty in maintaining confidentiality.

  • Performs other related duties as assigned or requested.

Your qualifications should include:

• High school diploma.

• Two (2) to five (5) years' experience in Revenue Cycle healthcare; hospital, medical group or Independent Practice Association (IPA). Has thorough knowledge of HMO, PPO, POS coverage rules.

• Preferably: Experienced with health insurance overpayment recoveries and credit balance research. AA or BA.

City of Hope employees pay is based on the following criteria: work experience, qualifications, and work location.

City of Hope is an equal opportunity employer. To learn more about our Comprehensive Benefits, please CLICK HERE.

Additional Information:

• This position is represented by a collective bargaining agreement.