Payment Processor/Poster

Omega Healthcare Management Services•Boca Raton, FL

2d•Onsite

About The Position

This position is responsible for researching patient and insurance credit balances from system work lists and requesting appropriate refunds. The role efficiently processes refund requests received from Insurance Companies and Responsible Parties, and authorizes and processes credit balances requested by staff within the organization, subject to authorization maximums. The Payment Processor/Poster also acts as a resource for billing office staff concerning credit balances.

Requirements

High school diploma or GED equivalent.
General knowledge of bookkeeping, basic accounting, and familiarity with insurance industry practices.
General knowledge of CPT and ICD9 codes.
Strong analytical, organizational, and communication skills required.
Minimum of two years related work experience in a health care environment.
Demonstrated knowledge of managed care principles, insurance industry practices, and medical terminology required.
Excellent verbal and written communication skills necessary.
Ability to operate data entry equipment and related computer systems.
Typing skills of 40wpm.
Ability to concentrate and pay close attention to detail.
Valid driver’s license when driving any vehicle for work-related reasons.
Writes, reads, comprehends and speaks fluent English.
Basic computer knowledge using word processing, spreadsheet, email and web browser.
Use of usual and customary equipment used to perform essential functions of the position.
Must be able to concentrate in a busy office, shared with other staff members.

Responsibilities

Ensure patient satisfaction through timely and effective processing of refund requests.
Respond to communication from third-party payors with requests for refunds.
Daily monitoring and resolution of credit balances via reports and/or correspondence, workques, patient, clinic phone calls or emails.
Review, audit, and process accounts in credit balance WQ’s identifying accounts for which a refund is due.
Effectively authorize and process refund requests submitted by staff outside and within the department.
Submit inquiries to payers to request a recoup be performed.
Trace errors, record adjustments to proper accounts, and determine the appropriate destination for refunds due.
Resolve account discrepancies by auditing account detail.
Balance all refunds processed to ensure amounts equal to Accounts Payable total refunds amount for the week.
Follow all Federal, State and industry requirements of overpayment timelines.
Completes special projects and monthly reports as assigned.
Demonstrate a professional image in dealing with the public, patients, families, and vendors.
Share responsibility through timely communication of identified problems to assure proper follow up is completed to expedite resolution of patient accounts issues.
Demonstrate competency with all applicable software programs.
Performs other duties as assigned.
Demonstrates the UnityPoint Health Values and Standards of Behaviors as well as adheres to policies and procedures and safety guidelines.
Demonstrates ability to meet business needs of department with regular, reliable attendance.
Employee maintains current licenses and/or certifications required for the position.
Practices and reflects knowledge of HIPAA, TJC, DNV, OSHA and other federal/state regulatory agencies guiding healthcare.
Completes all annual education and competency requirements within the calendar year.
Is knowledgeable of hospital and department compliance requirements for federally funded healthcare programs (e.g. Medicare and Medicaid) regarding fraud, waste and abuse.
Brings any questions or concerns regarding compliance to the immediate attention of hospital administrative staff.
Takes appropriate action on concerns reported by department staff related to compliance.