Medical, Payment, Posting, and Reconciliation Specialist

First Choice Community Healthcare•Albuquerque, NM

1d•Onsite

About The Position

The Medical Payment Posting & Reconciliation Specialist will monitor A/R aging, accessing the accounts for further attention by involving A/R; collect balances to ensure statements are processed and paid promptly. He/she will also manage and reconcile all payments; make sure it is posted into the patient’s account with the correct amount and adjustment. This role reports to the Central Billing Supervisor, who reports to the Director of Revenue Cycle Management.

Requirements

Data entry skills and working knowledge of computer required.
Exceptional customer service and interpersonal communication skills.
Proficient in examining documents for accuracy and completeness.
Ability to multitask and manage time effectively.
Ability to handle payment posting in accordance with detailed instructions.
Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, and decimals.
Ability to compute rates, ratios, and percentages.
Demonstrable functional knowledge of Microsoft Office applications, including Word, Outlook, and Excel.
Experience and proficiency with multiple practice management systems.
Electronic health records and knowledge of and experience with Medicaid and Medicare reimbursement rules and regulations.
Proficiency utilizing spreadsheet and word processing applications for billing and collections, perform detailed analysis and create executive summaries.
Apply billing and collection requirements of federally qualified health centers (FQHC).
Communicate with tact and diplomacy with diverse groups of people to include staff and providers, governing boards, government agencies, and insurance companies on behalf of the organization.
Manage multiple assignments with available resources within established guidelines and deadlines.
Establish and maintain a goal oriented, problem solving, results driven environment while performing as a working-assistant supervisor.
Knowledge and familiarity with compliance programs, corporate fully and comply with laws and regulations.
Good dexterity to operate personal computer and office equipment.
Occasional lifting and carrying related to office duties.
Capable of using office machines and personal computers for various computer assisted applications.
Must be able to read a computer monitor and outputs accurately.
Must be able to communicate clearly and accurately for work and safety compliance.
Work is mostly inside an office in a controlled environment.
Normal office safety precautions and practices are required.
High School diploma or equivalent required.
Two years’ experience in billing and claims in healthcare setting or FCCH billing externship.
Education or knowledge may be substituted for the experience requirement.

Nice To Haves

Associate or bachelor’s degree in business, Finance or Accounting preferred.

Responsibilities

Post all insurance and liability payments from Remittance and EOBs to appropriate accounts with minimum errors.
Apply manual payments and auto payments to accounts for payor types of Medicare, Medicaid and Commercial Insurances.
Analyze EOB information, including co-pays, deductible, co-insurance, contractual adjustments, denials and more to validate accuracy of patient balances.
Scan all EOBs into system and creates hardcopy file for original EOB's.
Add appropriate denial codes and comments to assure all necessary appeals and post payment follow up can take place.
Investigate the source of unidentified payment to ensure they are applied to appropriate accounts. If necessary, will contact the sender to clarify where the payment should be posted.
Reconcile shortage on both paper and electronic EOBs to determine proper allowance and correct write off.
Assist in updating the Direct Deposit Daily.
Assist in performing comparison of downloaded files to the Direct Deposit and correct any discrepancies.
Assist in setting up Electronic Remittance Advices (ERA) for Commercial and Medicare payors.
Assist in running and balancing credit cards daily.
Review deposits and reconcile site logs daily.
Contact patients, insurance or third-party administrators when clarification of information is needed to successfully post payment.
Handle telephone questions and concerns from customers; ensure complaints and inquiries are reported to management.
Report all Medicare credits quarterly to Medicare on appropriate form and supply all supporting documentation.
Research inquiries in a professional and courteous manner and work with Accounts Receivable team members, to identify and resolve escalated customer concerns in a timely manner, potentially without direct Supervisor oversight.
Partner with Team Lead and Supervisor to develop solutions to repeat customer concerns.
Act as point of contact for the team when Supervisor/Manager/Team Lead are unavailable.
Responsible for all other duties as assigned.