Providence Operations Support Analyst in Beaverton, Oregon
Providence St. Joseph Health is calling an Operations Support Analyst to our location in Beaverton, OR.
We are seeking a Operations Support Analyst who will perform a variety of tasks to effectively supporting the day-to-day activities of the OFT Team in its efforts to meet the objectives in the areas of Coordination of Benefits (COB), Third Party Liability (TPL), and Overpayment Recovery (OPR), ensuring maximum avoidance and appropriate timely recovery of over payments.
In this position you will have the following responsibilities:
Imaging and Scanning of refund checks, returned accidental injury and OIC inquiries, refund request letters, and enrollment forms.
Investigates returned checks due to bad address, incorrect payee (member or provider), or partial incorrect payments. Facilitates actions needed to ensure the correct payment is issued to the appropriate party. Action items may include voiding, reissuing the check and not reissuing the check. This includes all Facets checks including claims, capitation and commissions.
Performs research regarding US Bank fraud investigations on facets checks cashed in error.
Process CSI's in facets for all lines of business related to check processing functions (lost checks, voiding checks, issuing replacement checks, etc.).
Reprocesses claims in Facets based off received refunds where the entire claim will be adjusted down to $0.
Sets claims to auto recover when appropriate due to lack of receipt of requested refund.
Documents the receipt of accidental injury inquiries and routes to the appropriate analyst.
Pulls records and documents for TPL analysts related to records requests and subpoenas.
Generates and documents the receipt of the annual Other Insurance Coverage (OIC) inquiry.
Mail/Faxes: pick up, date stamp, and distributes. Handles returned mail.
Process weekly Bank Deposit for all of PPP. Ensures all incoming checks are secured until transferred to armored car for deposit processing.
Collects and distributes check to appropriate lock boxes, personnel or departments.
Medicare Secondary Payer (MSP), Medicare payment demand requests, annual MSP mailing and investigation of members age 65 to determine Medicare eligibility.
Generates refund requests based off entries into the refunds database, refund projects, Medicare Pharmacy refunds, and the BRE-termed eligibility report.
Be a strong advocate in adhering to BRITE behavior and by modeling it on a consistent daily basis.
Required qualifications for this position include:
1 year successful staff experience in a Health Plan setting.
1 year clerical experience in a similar office setting.
Preferred qualifications for this position include:
- Associate's Degree in Business Administration Services, or similar course of study.
About Providence in Oregon
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.
The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,
"Providence will provide the best care and service to every person, every time."
Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate 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.
Job Category: Claims
Req ID: 274080