Payment Application Specialist

WVU Medicine•Home Work - Monongalia County WV (Local), WV

About The Position

Responsible for posting insurance and/or patient payments to Epic and balancing those postings to bank deposits in a timely and accurate manner. Payment posting may involve electronic processing of remittance files or manual posting from paper remittances. The specialist assists the Departmental Coordinator with researching and resolving outstanding deposits and unidentified or missing payments. The position also researches payment errors, overpayments, refunds, undistributed balances, and missing charges; reconciles postings and deposits; communicates with payors, financial institutions, departments, and accounting; and maintains accurate documentation and reports. The role works in an office-type environment and requires sitting for extended periods, reading and comprehension, visual acuity within the normal range, and manual dexterity to operate business equipment.

Requirements

High school graduate or equivalent.
Excellent oral and written communication skills.
Excellent customer service and telephone etiquette.
Ability to use tact and diplomacy when dealing with others.
Knowledge of patient accounting principles and procedures.
Working knowledge of computers.
Ability to sit for extended periods.
Reading and comprehension ability.
Visual acuity within the normal range.
Manual dexterity to operate keyboards, fax machines, telephones, and other business equipment.

Nice To Haves

One year of medical billing or medical office experience.
Bookkeeping and cash-balancing experience.
Knowledge of medical terminology.
Knowledge of third-party payors.
Knowledge of business math.
Knowledge of ICD-10 and CPT coding processes.
Maintains knowledge of current online banking systems.

Responsibilities

Processes electronic remittances and initiates transaction posting in Epic.
Investigates transactions that do not post correctly and ensures they route to the appropriate accounts.
Identifies unidentified payment transactions routed to the clearing account and follows facility processes to move non-patient money to the correct general ledger account.
Balances postings to bank deposits using technical tools in Epic and Microsoft Excel.
Posts payments accurately and on time according to departmental goals and reports performance to management.
Documents accounts clearly and accurately.
Analyzes and reconciles patient-payment and other non-accounts-receivable cash postings to the patient accounting system and accounting department.
Uses system software, including online credit card systems and Epic.
Creates, enters, and assigns cash management batches.
Opens and distributes mail received from the post office and financial institutions for the entities whose services are billed.
Contacts third-party payors, business entities, and financial institutions to resolve unidentified or missing payments.
Accesses scanned information through the One Content imaging system.
Completes and reconciles bank deposits daily.
Uses remittance work queues to resolve payment errors.
Reviews and reconciles postings monthly with the Departmental Coordinator as needed.
Participates in educational programs to meet mandatory requirements and support job and personal growth.
Researches credit or undistributed self-pay balances in work queues and resolves them by applying balances to other outstanding accounts or processing approved facility or guarantor refunds.
Investigates insurance overpayments and takes appropriate action through the work queue to resolve variances.
Processes refund requests from third-party payors, clinical departments, other Revenue Cycle areas, and leadership.
Monitors accounts subject to special billing guidelines, including cosmetic, bariatric, IVF, and plastics, to ensure timely pre-payment application.
Works with accountants to maintain a list of unclaimed property and a spreadsheet for submission to the state.
Responds to calls from registration and customer service staff about cash-drawer issues and works to resolve them.
Ensures refund requests are received from accounts payable and processes checks for submission to third parties or guarantors.
Maintains current knowledge of payor payment provisions and local, state, and federal collection laws.
Contacts insurance companies or employers to determine eligibility, benefits, and payment information needed to refund or distribute payments.
Uses payor portals to initiate overpayment recoveries accurately.
Identifies missing charges and communicates with the appropriate coding manager for re-entry.
Completes Revenue Cycle leadership reports for bulk refunds to third-party payors.
Monitors work queues for inappropriate hospital payments posted to professional billing and works with the appropriate entity to correct posting.
Assists the hospital cashier’s office in locating and resolving missing receipts.
Helps the accounting department reconcile patient payments for the entity where the receipt was deposited.