The Payment Application Specialist researches, audits, reconciles and applies all cash receipts to AR accounts. Is skilled at researching, auditing, and reconciling payments for the respective departments. Is able to interpret explanations of benefits (EOBs) and reconcile and apply payments, recoupments, and provider level adjustments (PLBs). Identifies external payments and non-patient payments, and takes proper steps to transfer to the appropriate entity/general ledger account using designated adjustment codes. Processes payments and denials with the correct denial/remittance codes and applies denials/payments to the appropriate account/liability bucket. Handles processing of Non-Sufficient Funds (NSF) payments. Conducts in-depth research to resolve any balancing issues or to reconcile unidentified payments posted to clearing accounts. Identifies issues with ERAs/contractual calculations/payer compliance and escalates appropriately. Uses system generated reports, performs in-depth research and reconciliation of variances in the internal balancing tool. Recognizes and shares areas for process improvements. Is considered a subject matter expert (SME) in multiple areas of payment application and trains team members/documents processes/participates in workflow testing and other projects in order to improve the overall knowledge and function of their team. Performs other duties as assigned.
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Job Type
Full-time
Industry
Hospitals
Education Level
High school or GED
Number of Employees
1,001-5,000 employees