Payment and Reconciliation Specialist

Responsibilities

• Has an understanding of the accounts receivable posting process for medical billing including charges, payments, and adjustments.
• Posting financial transactions through the use of automated systems and team processes.
• Accurately interprets insurance explanation of benefits to ensure proper posting.
• Retrieves and uploads 835 remittance files into patient account system ensuring file reconciliation including reviewing and posting exception files.
• Participation in optimizing productivity within the area.
• Maintains knowledge of the work area and optimizes the use of available technology.
• Researches all information needed to process and complete insurance and/or patient refunds by obtaining information from providers, insurance plans, ancillary services staff, and patients.
• Accurately processes insurance and patient refund requests by demonstrating an advanced understanding of the coordination of benefits and eligibility requirements.
• Receives and processes all refunds utilizing insurance contracts and requirements for accuracy.
• Processes and posts refund checks as received into the patient accounting system.
• Establishes and maintains effective communication with physicians, staff, and other departments as required.
• Accepts and completes additional requests from the Cash Applications Supervisor.
• Adheres and understands the Business Office rules and regulations in regards to Medicare and HIPAA guidelines.
• Effectively forwards accounts requiring work up or resubmission to the business office staff.

• A minimum of two years' experience in medical billing and/or cash applications or equivalent experience in a healthcare environment.
• Prefer previous cash posting experience in a multiple lockbox environment.
• Must be able to communicate effectively with physicians, patients, and the public and be capable of establishing good working relationships with both internal and external customers.