Medical Payment Posting Specialist

Position Title: Medical Payment Posting Specialist

Reports To: Revenue Cycle Director

FLSA Status: Non-Exempt

Position Type: Full-Time

Work Schedule: Monday - Friday

Direct Reports: None

Position Summary:

Obtain and post all electronic and manual insurance and patient payments. Reconcile payments posted to the practice management systems and appropriate bank accounts. Provide reports to accounting. Post denials and forward all denials and correspondence to appropriate staff for resolution. Process weekly practice management systems’ reports for accounting department. Responsible for practice management systems’ file maintenance.

Essential Duties and Responsibilities:

• On a daily basis, post all manual insurance and patient payment checks received in the centers and the CBO into the appropriate practice management system within 2 days of receipt.
• Review the electronic funds report produced by accounting and pull all insurance electronic remittance advices from payer websites, or Availity; or match payments to paper explanation of benefits from payers’ and post to the practice management systems on a bi-weekly basis.
• Balance posted payments daily and document on tracking report.
• Identify denials, copy actual denial in the centers’ denials’ folder, document on denials’ tracking report and forward to accounts receivable representative for review, correction and reprocessing.
• Identify and forward attorney and accounts payable documents to the appropriate party.
• Pull front desk collections’ statistics from shared scan file and document on the tracking report.
• Balance monthly payment posting to practice management systems with bank accounts, prior to month end close.
• Run and distribute weekly reports to accounting.
• Handle all practice management systems’ file maintenance updates and corrections, i.e., insurance, referring physician, procedure code, etc., files.
• Maintain all payer websites’ accesses and set-up for all centers.
• Set up and maintain EDI, ERA, EFT application for payers.
• Function as back-up to Accounts Receivable Representatives.
• Perform related duties as assigned by supervisor.
• Maintain compliance with all company policies and procedures.

QUALIFICATIONS

Formal Education:

High School Diploma or equivalent.

Related Work Experience:

Minimum of 5 years’ medical payments posting experience preferred.

Licenses or Certifications: N/A

Specialized Knowledge/Skills:

• Knowledge of medical payments posting processes and billing software.
• Working knowledge of invoice (industrial/special circumstance billing).
• Knowledge of medical insurance terminology such as guarantor, primary, group ID and subscriber ID.
• Excellent typing (minimum 40 WPM) and computer usage skills, including Microsoft Office (Word and Excel).

Competencies:

• Customer service focus – ability to relate with people of diverse backgrounds, and provide excellent customer service and solutions to problems.
• Attention to detail.
• Sense of urgency.
• Excellent organizational skills.
• Ability to work independently, prioritize and perform several tasks without losing concentration.
• Professional and efficient verbal and written communications.
• Promote teamwork by working collaboratively with colleagues and management to achieve shared goals.

Physical Requirements:

• Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards; including meeting qualitative and/or quantitative productivity standards, and maintain regular in-person punctual attendance.
• Must be able to talk, listen and speak clearly on the telephone and in person with co-workers, patients, customers, and other visitors.
• Light physical effort. Requires long periods of sitting. Must be able to lift and carry up to 25 lbs.
• Constantly uses and operates standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

This description reflects management’s assignment of essential functions. It does not proscribe or restrict the tasks that may be assigned. This job description is subject to change at any time.

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