General Summary:
In this hourly position, the Payment Posting Specialist is responsible for posting claims receipts, analyzing explanation of benefits (“EOB”) data and resolving denials.
Qualifications:
- High School Diploma or equivalent
- Minimum of one year of work in a billing, intake, or A/R medical billing office
- Experience in processing, interpreting and understanding insurance company Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA) preferred.
- Minimum of one (1) year in medical insurance authorizations, medical billing collections or another relevant role.
- Experience working with Medicare and Medicaid remittance and payments preferred.
- Experience working with commercial insurance carriers (Blue Cross/Blue Shield, United Healthcare, etc.)
Responsibilities:
- Post claims receipts within 48 hours into the patient management system using accurate receipt date.
- Analyze Explanation of Benefits (EOB) to identify denials, payments and recoupments.
- Research unapplied payments, overpayments and under payments to identify the correct processing procedure for the payment.
- Post recoupments into patient management system using accurate recoupment date.
- Submit secondary and tertiary insurance bills.
- Prepares refund requests.
- Reconciles cash posting batches daily.
- Maintain a working knowledge of all health information management issues such as HIPAA and all health regulations.
- Maintain strict confidentiality.
- Coordinate with other revenue cycle departments for follow up on claim denials.
- Other reasonable job duties as assigned