Payment and Reconciliation Specialist- HYBRID
About The Position
The Center for Orthopedic Research and Education (CORE Institute) is seeking a Payment and Reconciliation Specialist. CORE Institute has been recognized by Ranking Arizona as #1 for Orthopedic Practices, #1 for Healthiest Healthcare Employers, #3 for Best Healthcare Workplace Culture, and a Winner in Best Places to Work. This role involves understanding the accounts receivable posting process for medical billing, including charges, payments, and adjustments, and posting financial transactions using automated systems and team processes. The specialist will accurately interpret insurance explanation of benefits, retrieve and upload 835 remittance files, and ensure file reconciliation. Responsibilities also include optimizing productivity, maintaining knowledge of the work area and technology, researching and processing insurance and patient refunds, and adhering to Medicare and HIPAA guidelines.
Requirements
- A minimum of two years' experience in medical billing and/or cash applications or equivalent experience in a healthcare environment.
- Must be able to communicate effectively with physicians, patients, and the public and be capable of establishing good working relationships with both internal and external customers.
Nice To Haves
- Prefer previous cash posting experience in a multiple lockbox environment.
Responsibilities
- Has an understanding of the accounts receivable posting process for medical billing including charges, payments, and adjustments.
- Posting financial transactions through the use of automated systems and team processes.
- Accurately interprets insurance explanation of benefits to ensure proper posting.
- Retrieves and uploads 835 remittance files into patient account system ensuring file reconciliation including reviewing and posting exception files.
- Participation in optimizing productivity within the area.
- Maintains knowledge of the work area and optimizes the use of available technology.
- Researches all information needed to process and complete insurance and/or patient refunds by obtaining information from providers, insurance plans, ancillary services staff, and patients.
- Accurately processes insurance and patient refund requests by demonstrating an advanced understanding of the coordination of benefits and eligibility requirements.
- Receives and processes all refunds utilizing insurance contracts and requirements for accuracy.
- Processes and posts refund checks as received into the patient accounting system.
- Establishes and maintains effective communication with physicians, staff, and other departments as required.
- Accepts and completes additional requests from the Cash Applications Supervisor.
- Adheres and understands the Business Office rules and regulations in regards to Medicare and HIPAA guidelines.
- Effectively forwards accounts requiring work up or resubmission to the business office staff.
Benefits
- Competitive Health & Welfare Benefits
- Monthly $43 stipend to use toward ancillary benefits
- HSA with qualifying HDHP plans with company match
- 401k plan after 6 months of service with company match (Part-time employees included)
- Employee Assistance Program that is available 24/7 to provide support
- Employee Appreciation Days
- Employee Wellness Events
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
