Payment Poster

ORTHOPAEDIC ASSOCIATES OF WISCONSIN • Village of Pewaukee, WI

18h • Hybrid

About The Position

The Medical Billing Payment Poster is essential for maintaining financial accuracy within the organization. This role involves accurately posting payments from both insurance providers and patients, processing refunds, and reconciling accounts. A strong attention to detail is required, along with a solid understanding of medical billing procedures. Proficiency in handling insurance credits, electronic remittances, and account balancing is also necessary. This position requires exceptional analytical skills to efficiently identify and resolve discrepancies while ensuring compliance with industry regulations.

Requirements

• High School Diploma or equivalent
• 2-4 years of experience in medical billing, payment posting, and account reconciliation.
• Experience with insurance and patient refunds and insurance credits.
• Knowledge of electronic 835 transactions and remittance advice interpretation.
• Familiarity with Claim Adjustment Reason Codes (CARC).
• Proficiency in Excel and ability to perform financial reconciliations.
• Experience balancing accounts and handling bank-to-book transactions.
• Ability to clearly explain billing procedures, insurance details, and payment options to patients, as well as effectively communicate with healthcare providers and insurance companies.
• Accurate documentation of billing information and patient interactions.
• Strong interpersonal skills to handle patient inquiries and resolve billing issues in a professional and empathetic manner.
• Proficiency in basic math operations for calculating charges, payments, and adjustments.
• Understanding of billing cycles, insurance reimbursement rates, and payment plans.
• Ability to perform reconciliations and handle financial discrepancies.
• Ability to analyze billing data, identify trends, and detect errors or inconsistencies.
• Ability to identify billing issues, investigate causes, and implement solutions.
• Prioritizing tasks based on urgency and importance.
• Evaluating complex billing situations, making informed decisions, and considering the potential impact on patients and the hospital.
• Ensuring all billing practices comply with legal and regulatory standards, maintaining patient confidentiality, and handling sensitive information responsibly.
• Ability to work under pressure, meet deadlines, and handle multiple tasks simultaneously.
• Skilled in using medical billing software and electronic health records systems.
• Familiarity with coding software and tools.
• Accurate and efficient data entry skills for processing patient information, billing codes, and insurance details.
• Ability to learn and adapt to new technologies and software updates.
• Proficiency in using office software for documentation and reporting.

Nice To Haves

• Associate Degree in Accounting
• Experience with Epic and other electronic health record (EHR) or billing systems.

Responsibilities

• Verifies calculations and ensures allowed charges, reimbursement amount and contractual disallowance are posted correctly based on the remittance advice.
• Ensure requesting/utilizing the correct adjustment codes as defined in policy at the time of posting and brings incorrect codes to the attention of a supervisor or lead.
• Ensures appropriate amounts are allocated and posted to individual patient accounts and that balancing procedures are maintained for the posting of payment and adjustment batches.
• Responsible to work assigned work queues, reports and spreadsheets to resolve errors or exceptions. May be responsible to download reports or files from secured websites for processing.
• Investigates recoupments, interest payments and miscellaneous payments directed to specific clearing accounts requiring research.
• Reports overpayments or refunds as necessary when identified during the payment posting process. Brings payment discrepancies to the attention of their supervisor or lead.
• Ensures the daily deposits are posted and balanced per documented procedures.
• Ensures payments and adjustments posted electronically are completed and balanced.
• Works closely with Finance to investigate and resolve any out-of-balance conditions between the deposit and postings.
• Distributes copies of remittance advices/explanation of benefits to staff as needed.
• Ensures the correct ANSI code or comment code is used when posting denials or partial payments.
• Prioritizes work effectively in order to prevent backlogs. Communicates workload issues to supervisor or lead.
• Maintains productivity standards as outlined in the Revenue Cycle department.
• Participate in department meetings, workgroup meetings, and training sessions.
• Ability to adapt to change in a positive, sensitive and forward-thinking manner in demanding situations.
• Provides limited training to partners after becoming efficient, as well as on an as-needed basis for back-up situations.
• Special projects as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED