Medical & Reconciliation Specialist

Medical Payment Posting & Reconciliation Specialist Duties and Responsibilities

• Ensure prompt and regular attendance, meeting BHG attendance standards.
• Accurately process manual and electronic remittance advice (ERA) payments and adjustments.
• Balance all daily deposits across centers, ensuring cash reports are up to date.
• Collaborate with the accounting department on bank reconciliations, cash tracking, and cash management operations.
• Interpret and resolve payment issues through extensive primary and secondary research, including locating missing EOBs and insurance payments.
• Work across multiple systems to post and reconcile insurance payments accurately.
• Investigate and resolve any discrepancies related to deposits or payment postings.
• Communicate pertinent information to team members and management as needed.
• Prepare daily and monthly cash reports and identify underpayments, over payments, or credits for resolution.
• Retrieve missing payment information from payers via various channels (phone, portals, clearinghouses).
• Review account debits and credits, taking necessary action to address any issues.
• Perform other duties as assigned by the supervisor.

• Responsible for complying with all federal, state and local regulatory agency requirements.
• Responsible for complying with all accrediting agencies.

• Participate in community and public relations activities as assigned.

• Responsible for the achievement of assigned specific annual goals and objectives.
• Demonstrates the belief that addiction is a brain disease, not a moral failing.
• Demonstrates hope, respect, and caring in all interactions with patients and fellow Team Members.
• Establishes and maintains positive relationships in the workplace.
• Can work independently and under pressure while handling multiple tasks simultaneously.
• Makes decisions and uses good judgment with confidential and sensitive issues.
• Deals appropriately with others in stressful or other undesirable situations.

• Participate in and provide in-service trainings as required by federal, state, local, and accrediting agencies.
• Attend conferences, meetings and training programs as directed.
• Participate in and/or schedule and attend regular in-service trainings.

• Demonstrated commitment to valuing diversity and contributing to an inclusive working and learning environment.

The ideal candidate must hold and maintain a valid driver’s license. Experience and understanding of chemical addiction is preferable. In addition to meeting the qualifications, the ideal candidate will embody the following characteristics and possess the knowledge, skills and abilities listed below:

• At least 3 years of experience in medical payment posting and reconciliation.
• Working knowledge of Medicare, Medicaid, Managed Care, and Commercial Insurance plans preferred.
• Advanced reconciliation and analytical skills specific to medical billing processes.
• Proficiency in Excel.
• Familiarity with clinical terminology, ICD-10, and CPT codes.
• Ability to read and interpret Explanation of Benefits (EOBs), HCFA regulations, and HIPAA compliance requirements.
• Proficiency in 10‑key touch and keyboarding skills.
• Excellent verbal and written communication skills.
• Strong interpersonal skills and the ability to foster teamwork.
• Superior attention to detail and organizational abilities.
• Proficiency with Microsoft Office Suite or related software.

• Communicate effectively by phone or in person.
• Vision adequate to read correspondence and computer screens.
• Prolonged sitting, some bending, stooping, and stretching.
• Manual dexterity for operating office equipment.
• Variable workload and periodic high stress.
• Standard medical office environment.
• Interaction with patients with various health and legal issues.
• Extended keyboarding periods.

The above statements are intended to describe the general nature and level of work being performed by team members assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of team members so classified. All team members may be required to perform duties outside of their normal responsibilities from time to time, as needed, and this job description may be updated at any time.

BHG is an equal opportunity, affirmative action employer providing equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity or expression, national origin, protected veteran status, disability status or any other legally protected basis, in accordance with applicable law.

• Mid-Senior level

• Full-time

• Health Care Provider
• Hospitals and Health Care