Payment and Reconciliation Specialist- HYBRID

Healthcare Outcomes Performance Company • Phoenix, AZ

1d • Hybrid

About The Position

The Center for Orthopedic Research and Education (CORE Institute) is seeking a Payment and Reconciliation Specialist. This role involves understanding the accounts receivable posting process for medical billing, including charges, payments, and adjustments. The specialist will post financial transactions using automated systems and team processes, accurately interpret insurance explanation of benefits for proper posting, and retrieve/upload 835 remittance files into the patient account system, ensuring file reconciliation and reviewing exception files. Responsibilities also include optimizing productivity, maintaining knowledge of the work area and technology, researching information for insurance and patient refunds, and accurately processing these refunds with an understanding of coordination of benefits and eligibility requirements. The role also involves processing refund checks, maintaining communication with physicians and staff, completing additional requests from the Cash Applications Supervisor, and adhering to Business Office rules, Medicare, and HIPAA guidelines. Accounts requiring workup or resubmission will be forwarded to the business office staff.

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

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed