Payment Posting & Reconciliation Specialist-II

Senior PsychCare • Houston, TX

2d • $18 - $22 • Onsite

About The Position

The Medical Payment Poster is responsible for payment posting. An ideal candidate would be responsible for ensuring precise payment posting, maintaining
accurate patient records, verifying copays and deductibles, resolving data discrepancies, and pursuing outstanding accounts.

Requirements

• Minimum 2 years + of recent Healthcare payment posting experience (Required)
• Minimum of 1 year + experience in Monthly Payment Reconciliation (Required)
• Ability to work independently and prioritize workflows (Required)
• Payer portal and clearinghouse experience (Required)
• High school diploma or equivalent; additional education in healthcare administration or related field is a plus.
• Strong understanding of insurance payment methodologies, Explanation of Benefits (EOBs), remittance advice, and insurance claim processing.
• Excellent attention to detail and accuracy in data entry and reconciliation.
• Effective communication skills, both written and verbal, for interacting with insurance providers, colleagues, and patients.
• Ability to work independently and as part of a team, collaborating to resolve payment-related issues.
• Strong organizational skills and the ability to prioritize tasks in a fast-paced environment.

Nice To Haves

• Familiarity with medical coding and billing codes (CPT, ICD-10) is a plus.
• Knowledge of Medicare/Medicaid and MCOs ’ billing regulations and procedures is preferred
• Recent Availity Experience

Responsibilities

• Pull remits electronically and manually for daily deposits
• Accurately post remits via ERA, EFT, and paper remits
• Process checks and credit card payments and post to accounts
• Research unapplied payments, overpayments, and credits
• Post all zero remits, negative, and forward balance remits
• Reconcile daily and monthly reports to avoid variance
• Transfer to secondary, tertiary payor, and/or self-pay for accuracy
• Assist in maintaining the RCM department KPI’s/metrics
• Manage Payment posting projects
• Ensure the unapplied payments are allocated daily and monthly
• Work closely with the Finance team to resolve PLB and variance ledgers
• Review insurance payment documents, including Explanation of Benefits (EOBs), remittance advice, and payment checks, to accurately determine payment amounts and reconcile them against billed services.
• Utilize our electronic health records (EHR) and billing software to post insurance payments to patient accounts accurately and promptly.
• Identify discrepancies between billed amounts and received payments and take appropriate actions to rectify any discrepancies, including contacting insurance providers or third-party payers.
• Collaborate with other operational teams to ensure proper coding and billing practices, helping to prevent payment denials and delays.
• Maintain a thorough understanding of various insurance plans, payment methodologies, and reimbursement guidelines to ensure accurate posting and reconciliation.
• Monitor and track outstanding insurance payments, investigating and resolving any discrepancies or payment delays.
• Generate and distribute regular reports summarizing payment posting activities, outstanding payments, and reconciliation efforts to relevant stakeholders.
• Stay up to date with changes in insurance regulations, billing codes, and payment processing procedures to ensure compliance with industry standards.
• Proactively identify opportunities to improve business results and/or to alert business units of trends, anomalies or health plan rules and decisions that need attention.
• Participate in team meetings and training sessions to continuously improve knowledge

Benefits

• Competitive salary, commensurate with experience
• Paid Time Off as well as Company-paid Holidays
• Comprehensive benefits package including Medical, Dental, and Vision benefits
• Life Insurance
• Short- and Long-Term Disability
• 401(k)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 1-10 employees