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Company: Tri-City Medical Center
Location: Oceanside
Posted on: May 20, 2023

Job Description:

Tri-City Healthcare District has been serving the North County region for almost 60 years and remains committed to providing high quality healthcare and community services for every individual we encounter regardless of race, color, ethnicity, gender, sexual orientation, disability or socioeconomic status.
Our mission is to advance the health and wellness of the community we serve. In order to achieve our mission, we see, hear and listen to our front line healthcare workers, employees, medical staff and all community stakeholders in order to understand and meet our community's needs.
Position Summary:
Responsible for researching all credit balances, refunds and unidentified monies received from patients, third party payers and government entities. Demonstrates extraordinary commitment to excellence by adhering to departmental excellence criteria.
Major Position Responsibilities:
The position characteristics reflect the most important duties, responsibilities and competencies considered necessary to perform the essential functions of the job in a fully competent manner. They should not be considered as a detailed description of all the work requirements of the position. The characteristics of the position and standards of performance may be changed by TCMC with or without prior notice based on the needs of the organization.

  • Maintains a safe, clean working environment, including unit based safety and infection control requirements.

  • Responsible for researching and resolving all credit balances in the patient accounting system. Utilizes QMS to reach daily and weekly goals.

  • Responsible for correction of contractual adjustments according to patient accounting compliance guidelines.

  • Completion of Medi-Cal and Medicare credit balance reports within 30 days after the previous quarter ended.

  • Responsible for preparing refund-tracking log for insurance refunds that go to accounts payable for processing.

  • Responsible for researching and resolving credit balances for all patients and/or third party payers.

  • Responsible for data entry of contractual adjustments submitted by the collectors and for researching, resolving and reconciling any unidentified payments to the appropriate patient account.

  • Prepare formal request for refund when applicable.

  • Review and reconcile all transactions posted to credit balance accounts and unidentified payments to verify completeness of charge posting, accuracy of payment and contractual allowance posting, and accuracy of credit balance calculation.

  • Obtain approval for refund and submit for processing.

  • Complete daily and weekly volume/productivity management reporting.

  • Takes personal initiative to bring forward process/performance improvements as identified. Performs special assigned duties to meet the needs of the department.

  • Workstations, desk and surrounding area are to be kept neat, clean and safe for other employees to work at any time.

  • Other duties as assigned.


    • Requires two years of accounts receivable experience in a healthcare environment.

    • Must be able to use 10-key adding machine by touch.

    • Requires 2-year data entry/CRT experience and 1-2 year demonstrated working knowledge of medical explanation of benefits (EOB) banking, medical billing and medical terminology.

    • Able to perform basic mathematical calculations, balance and reconcile numbers. Requires typing skills of 45WPM.

    • Requires working knowledge of Microsoft Word, Excel and Microsoft Outlook.

    • Oral and written communications is necessary to be successful in this position.

    • Excellent human relations' skills including listening, conflict resolution, coaching, and team building.

    • Must have ability to demonstrate flexibility in response to unexpected change in work volume and hospital staffing needs.

    • Process oriented skills with ability to handle multiple projects simultaneously by prioritizing responsibilities and meeting deadlines required.

    • Ability to ensure the confidentiality and rights of patients and the confidentiality of hospital and departmental documents required.


      • High school diploma or GED, required with accounting or banking experience. Healthcare experience preferred.

        Each new hire candidate who is offered employment must pass a physical evaluation, urine drug screen and pre-employment background checks before starting work.
        *Salary/Hourly Wage range based on experience.
        To protect the health of patients and staff, and to comply with the new State of California mandates, all job offers are contingent on the successful engagement in the TCMC COVID-19 vaccination program (fully vaccinated with documented proof or approved exception/deferral.)
        TCHD is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with a disability.
        Req No: 2023-12508
        Shift: Day
        Work Schedule: 8:00-4:30
        External Company Name: Tri City Healthcare District
        External Company URL: http://www.tricitymed.org/
        Cost Center/Dept: 8532 - Patient Accounting

Keywords: Tri-City Medical Center, Oceanside , PAR-REFUND/CREDIT REPRESENTATIVE - $1,000 Sign-On Bonus, Other , Oceanside, California

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