Medical Billing Payment Poster- Pewaukee

Description

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, reconciling accounts, initiating and maintaining electronic remittance advice and payment enrollments. 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.

Reports to:

CFO

• 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.
• Calculates self-pay discounts and application of self-pay money.
• Reports over payments 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.
• Balance Daily Bank Deposits to Posted Deposits and works closely with Finance to investigate and resolve any out‑of‑balance conditions.
• 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 to prevent backlogs. Communicates workload issues to supervisor or lead.
• Enrolls payers in Electronic Fund Transfers to minimize payment collection lag.
• Evaluates payer for enrollment in Electronic Remittance Advice (ERA) to improve efficiencies in payment posting.
• Triages ERA issues between OAW, EPIC and the Clearinghouse and creates and manages Support tickets until resolved.
• 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.

An individual in this position must be able to perform the essential duties and responsibilities listed above successfully. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of this position.

The above list reflects the general details necessary to describe the principle and essential functions of the position and shall not be construed as the only duties that may be assigned for the position.

• Education:
  
  High School Diploma or equivalent
• Preferred:
  Associate Degree in Accounting
• Experience:
  
  2-4 years of experience in medical billing, payment posting, and account…