Trip Audit and Member Reimbursement Specialist

• Location: NE Glisan; Currently Remote
• Position Reports To: Trip Audit Supervisor
• Full-Time Equivalent: 1.0 FTE

Summary

Ride Connection is looking for a collaborative relationship builder to join our Trip Audit team as a Trip Audit and Member Reimbursement Specialist.

The Trip Audit and Member Reimbursement Specialist supports the Trip Audit Supervisor and members and partners within the Medicaid Non-Emergent Medical Transportation (NEMT) network. The person in this role is responsible for assisting with the timely and accurate processing of Appointment Verification Forms (AVFs) submitted by members seeking reimbursement under NEMT for mileage, meals, lodging, and other forms of reimbursement. The Trip Audit and Member Reimbursement Specialist also assists in auditing vehicle-provided NEMT trips before the providers are issued payment. The Trip Audit and Member Reimbursement Specialist reports to the Trip Audit Supervisor.

This is a full-time, non-exempt position with a starting salary of $19.47 per hour. Ride Connection offers an excellent benefits package, including comprehensive medical, dental, and vision insurance, an Employee Assistance Program, 403(b)-retirement plan with full vestment on day one, Flexible Spending Accounts with a $500 employer contribution, 10 days of paid vacation in your first year with increases every three years, six floating holidays that can be used at any time, a sick leave bank separate from your time off bank, and Trimet annual public transportation passes.

Who You Are

• You value relationships and believe that relationship-building is about cultivating and sustaining meaningful connections that support and uplift everyone.
• You are a community builder by nature. You view community engagement as key to supporting underserved communities and working with your team and teams across an organization or agency for the common good.
• You are known for your eye for detail. Double-checking and triple-checking are a part of how you operate.
• You can maintain your composure in a crisis or tense situation and help others keep their cool.
• You can roll with the punches and change gears when needed. You split your attention between individual work projects, team projects, and customer service without losing a beat.
• You are a lifelong learner, always looking for and finding new nuggets of knowledge to expand how you view the world.
• You have a knack for quickly learning new technology and the ins and outs of new programs – but you’re not afraid to ask questions or seek assistance if there’s something you don’t understand.
• You understand the importance of feedback – giving feedback that is empathic and supportive and how to engage with and process feedback you receive from others.

What You’ll Do

Member Reimbursement

• Assist with the timely and accurate processing of Appointment Verification Forms (AVFs). This includes:
  • Receiving AVFs via eFax, email, or mail
  • Reviewing AVFs to determine if reimbursement should be approved or denied
  • Performing a secondary review of AVF denials
  • Issuing denial letters when members are not approved
  • Post-trip appointment verification, which includes contacting medical offices to confirm members attended their appointment(s)
  • Member education, customer service, and advocacy
  • Auditing trips prior to reimbursement being approved
  • Submitting reimbursement summary information to the NEMT Payments team so that members are reimbursed
  • Service coordination for members obtaining medical care and services outside of the Tri-County area
  
  

Trip Audit

• Assist in the auditing of vehicle provided Non-Emergency Medical Transportation (NEMT) trips prior to the providers being issued payment for services. This auditing includes:
  • Vetting trips for accuracy and integrity
  • Considering and understanding the potential for fraud, waste, or abuse and how that applies to NEMT trips
  • Running weekly reports for auditing specific focus areas
• Maintain a working knowledge of trip purposes, basic credentialing, funding sources, vehicle types, payment structures, service areas, and other data variations that may impact auditing.
• Work with colleagues and NEMT network partners on incoming emails and phone calls to determine how to best address various trip performance and payment issues.

Qualifications

At least one year of auditing or data analysis experience. Experience with and comfort with the Microsoft Office suite, especially Excel. Must be able to pass a DMV check. Must pass a National Criminal Record Check, which includes fingerprint identification.

Preferred Qualifications

• Bilingual.
• Multi-lingual.
• Experience using advanced Excel functions, including building pivot tables, and manipulating large data sets.
• Experience or familiarity with transportation program management.
• Experience or familiarity with demand-response public transportation.
• Experience using conflict resolution and de-escalation techniques.
• Experience, lived or otherwise, working with older adults and people with disabilities.

Application Instructions

To apply for this position, please send your resume and cover letter to jobs@rideconnection.org.You can submit these documents in any format, but pdf works best. Please share what skills and experiences you would bring to this role in your cover letter.

Applications will be considered as submitted, so you are encouraged to apply early. Applications will continue to be accepted until the position is filled.

About Ride Connection

Ride Connection is a private, non-profit organization based in Portland, Oregon. We offer ways for people to access the goods and services they need to survive and thrive. By giving people the means to get around, we offer independence, health, and inclusion.

The Ride Connection network comprises a collection of agencies that serve older adults, people with disabilities, and low-income individuals by offering a variety of transportation options in Clackamas, Multnomah, and Washington counties.

Together, we provide over 500,000 rides and support more than 2,000 individuals with training and access to public transportation each year.

You can learn more about Ride Connection at www.rideconnection.org.