- Serve as a member of a cross-functional team whose primary responsibilities are:
- Identifying other party resources for primary payment of claims
- Providing technical and customer support to the Service Operations Claims and Customer Service teams, and multiple internal and external customers in the areas of:
- Coordination of Benefits (COB)
- Third Party Liability (TPL)
- Overpayment Recovery (OPR)
- Be responsible for maintaining other insurance information
- Determine order of benefits
- Coordinate recoupment and/or avoidance of payment as appropriate in an effort to reduce medical expense
- Be responsible for requesting refunds for overpayments made in error
- Follow-up with providers and members to ensure prompt refunds are received and posted to members claim history
- Negotiate a fair and just settlement of third party cases with legal counsel and adverse carrier situations
- This position is considered to be a hybrid role, working a combination of in-office / work from home defined by manager and departmental needs
- We welcome residents to apply who live within a daily commutable distance of our office location listed below:
- Oregon: Multnomah / Washington Counties
- Bachelor's Degree -OR- a combination of equivalent education and experience
- 1+ years of claims adjudication experience in an HMO and/or PPO environment
- 2+ years of experience in a healthcare environment
- 2+ years of experience with Facets claims adjudication software
-
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Associate Financial Transaction Analyst Hybrid - Beaverton, United States - Providence Service
Description
Description
Providence Health Plan caregivers are not simply valued – they're invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Providence Health Plan is calling an Associate Financial Transaction Analyst who will:
Please note the following important details regarding this position:
Required qualifications for this position include:
Preferred qualifications for this position include:
Why Join Providence?
Ourbest-in-class benefitsare uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering ourMissionof caring for everyone, especially the most vulnerable in our communities.
About Providence
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID: 281195
Company: Providence Jobs
Job Category: Financial Transactions
Job Function: Health Plans Services
Job Schedule: Full time
Job Shift: Day
Career Track: Business Professional
Department: 5018 OPS FINANCE TRANSACTIONS OR REGION
Address: OR Beaverton 3601 SW Murray Blvd
Work Location: Murray Business Ctr Beaverton-Beaverton
Pay Range: $ $38.60
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
