Payment Poster

SUMMARY

The Payment Poster will report directly to the Payor Relations & Customer Experience (PRCE) Manager, while working closely with Finance, Customer Experience Specialist (CEx), and Denial Management Specialist personnel to support financial objectives through accurate and efficient posting of payments received.

The Payment Poster is responsible for the posting of all inbound payments and no-pay Explanation of Benefits (EOB), as well as reviewing credit balances and processing refund requests. The ideal candidate will have a strong attention to detail and a sense of urgency with regard to payment posting.

ESSENTIAL DUTIES AND RESPONSIBILITIES include but are not limited to the following:

• Posts payments to RPM system within 72 hours and transfers any deductible/coinsurance/copay to patient responsibility.
• Records bath totals by date and balances batches and run transaction reports.
• Reconciles credit balances for patient, client, and insurance accounts, reviewing and verifying the validity of any refund processed.
• Reconcile all unidentified cash and verify all EFT deposits and scanned checks have been posted by month end.
• Properly documents payment denials in the RPM system and communicate denials to appropriate denial management representatives in a timely manner. This includes identifying payments not being paid at allowed/contracted amount and communicating this to PRCE leadership.
• Assists other team members with payment research or other payment related questions as needed.
• Maintains professional knowledge regarding medical billing and coding procedures, insurance carriers, federal programs, etc.
• Follow all compliance and HIPAA standards when documenting in the RPM system and communicating with payors.
• Ability to handle multiple projects at the same time but remain organized, strong sense of urgency for schedules.
• Uphold company mission and values through accountability, innovation, integrity, quality, and teamwork.
• Regular and reliable attendance.
• Excellent verbal and written communication skills and the ability to work in multiple systems interfaces at one time.

MINIMUM QUALIFICATIONS

• High School Degree/General Education Degree and 4 years of relevant experience in Customer Service, medical industry payment posting or relevant experience as outlined in the essential duties in lieu of bachelor's degree.
• Demonstrated ability to think critically and apply judgement in actioning and resolving accounts.
• Strong understanding of medical billing, insurance, and data entry.
• Advanced proficiency in customer service systems, CRMS, Phone systems, Billing Platforms.
• Fluency in English required. Spanish / Bilingual a plus
• Proficiency in Microsoft Office, to include Word, Excel, Outlook, SharePoint.
• Demonstrated ability to perform the Essential Duties of the position with or without accommodation.
• Maturity and good judgment to understand when to exercise initiative and handle queries directly, and when to escalate queries to higher authority.
• An excellent team player - highly effective at working with others and capable of working independently most of the time.
• Ability to multi-task and high attention to detail. Must be able to work in a fast paced, time-sensitive environment.
• Must have superior interpersonal and organizational skills. Excellent listening, oral and written communication skills. A high level of empathy, enthusiasm, and self-confidence.
• Professional telephone manner.

PREFERRED QUALIFICATIONS

• Clinical / Medical or other ancillary service type background.
• Minimum of 4 years payment posting in Health Care, Lab, DME Pharmaceutical industry preferred.
• Bachelor's Degree preferred.
• Significant PC knowledge & Windows OS experience. Skilled competence with Five9, XiFin, Microsoft Office, Salesforce.com a plus.

EDUCATION and/or EXPERIENCE

Position generally requires a high school diploma or general education degree (GED) and four years of related experience in a medical billing payment posting required; or completion of a medical vocational school. Should be familiar with accessing Medical Coding (CPT & Diagnostic Codes) and HIPPA rules and regulations. Should understand medical terminology, EOB's and CMS 1500's and insurance classifications such as HMO, PPO, Medicare and private insurances. Familiarity with insurance plans, third party administrators, and governmental rules and regulations preferred. Candidates must be able to manage a high volume of work while maintaining attention to detail and accuracy and demonstrate excellent oral and written communication skills. Computer skills required to operate practice management system (i.e., use Window operating system, conduct Internet searches, communicate by email, etc.).

LANGUAGE SKILLS

Must be fluent in both verbal and written English. Must have the ability to speak effectively in order to provide information and respond to questions from managers, employees, patients, and payor representatives. Must have the ability to read and comprehend simple instructions, correspondence, and memos. Ability to prepare routine appeals and effectively communicate electronically and via telephone. Ability to respond to patients in an empathetic and professional manner. Ability to effectively present information in one-on-one and small group situations with other employees of the organization.

MATHEMATICAL SKILLS

Ability to add and subtract numbers, to multiply and divide with 10's and 100's and to compute percents and fractions. Ability to perform these operations using units of American currency.

REASONING ABILITY

Ability to recognize problems, collect relative data, establish facts, draw valid conclusions and take appropriate action under close supervision. Ability to understand and appreciate HIPPA rules and regulations regarding patient privacy.

CERTIFICATES, LICENSES, REGISTRATIONS

None required.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit for extended periods of time in front of a computer monitor. The employee is required to use headphones for extended periods of time while handling phone calls. The employee is required to perform extensive data entry. The employee frequently is required to use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually quiet.

All qualified applicants are considered for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status or other protected class.