Cash Posting/Credit Balance Specialist I

Location: Commerce Place

Work Days: 8-4:30

Category: Clerical and Administrative Support

Department: Cash Posting Applications

Job Type: Full time

Work Shift: Day

Hours/Week: 40.00

Union: No

Union Name: Non Union

DEPARTMENT DESCRIPTION:

Patient Financial Services is responsible for billing healthcare claims to third party payers for hospital and professional services. The department provides critical oversight of the revenue cycle for Cambridge Health Alliance including actively participating in front end and back end processes. The department is organized under the following units: Single Billing Office/Customer Service, HB Commercial, HB Government, HB/PB Health Safety Net, and PB - All Payers. The department includes Billing Managers, Billing Supervisors and Team Leads, Billing Analyst and A/R Follow-up Billers. Key functions include Billing, Denial Management and Insurance Follow-up. The department interacts with a variety of departments including IT, Case Management, Central Referral Office, Financial Controls and many Ancillary departments.

Summary:
The Cash Posting and Credit Balance Specialist is responsible for the daily activities of the cash posting and credit balance processes for the Patient Financial Services Department. Ensures the timely and accurate posting of insurance and patient payments, charge adjustments, deductibles, copayments, non-covered, denied amounts and refunds.. Support the accurate reconciliation of cash posting of paper and electronic remittances. Works with Supervisor and Team Leads and follows documented policy and procedures to ensure transactions are accurate to the account level, including transactions that result in possible overpayments or credits to the account.

Responsibilities:
• Post electronic remittance advices on a daily basis ensuring timely and accurate posting and reconciliation of payments from payers and patients.
• Reconcile Lockbox deposits on a daily basis.
• Compile lockbox deposits from Bank and Document Image vendor for distribution to Payment Posting teams.
• Work document image work queues that help to organize scanned images of paper EOBs and correspondence.
• Post manual denials received in lockbox correspondence daily/weekly.
• Record transactions and correct invalid/incorrect entries in Epic and MS Access cash database.
• Review EFT/ACH transactions from the bank and work the Epic Cash Management module to ensure deposits are accounted for and a matching remittance is identified to post to the system. This can include deposits from multiple sources including Depository and Lockbox accounts.
• Alert Team Leads/Manager of missing files and log deposits that are missing files for the EDI team to research.
• Support account level reconciliation within the Epic system, including the use of databases and spreadsheets to reconcile back to actual cash and data files. Monitor automated payment reconciliation reports for discrepancies and resolve variance issues.
• Work closely with other departments including billing, customer service, accounting, and finance to ensure all needs are met.
• Process credit card payments and obtaining approval codes and posting payments to appropriate patient's accounts into Epic.
• Read and interpret Explanation of Benefits (EOB) with denial code review to support the accuracy of payment and adjustment posting.
• Identify issues with internal cash posting processes. Work with the Cash Posting Manager on problematic insurance payment issues and provide solutions to create an efficient process.
• Work closely with other departments including billing, customer service, accounting, and finance to ensure all needs are met.
• Read and interpret Explanation of Benefits (EOB) with denial code review to support the accuracy of payment and adjustment posting.
SPECIFIC CREDIT BALANCE DUTIES:
• Responsible for follow up on credit balance accounts
• Responds to patient inquiries and Insurance phone calls regarding account balances and refunds
• Handle correspondence received from payers requesting refunds
• Reports on root causes of Credit Balances to management
• Work payment posting work queues including credit, adjustment and refunds. Research all credit balances to ensure balance is actual refund balance, as opposed to miss-posted cash, incorrect discount or adjustment, or payment transfer, prior to processing refunds for both insurance and patient amounts.
• Other duties as assigned by Management

Qualifications: 

Education/Training: Associate’s Degree preferred
Two to three years of experience in a healthcare or related setting with demonstrated experience in Cash posting operations. 

Knowledge of accounting and experience with Government and Commercial plans and Self-pay payments. 

Ability to read and understand the different types of health insurance Explanations of Benefits (EOBs) and 835 files. 

Ability to work collaboratively with the Supervisors. 

Experience and understanding of hospital information systems such as Epic. 

Software skills utilizing Google and Microsoft office products such as spreadsheets, word processing, presentation software, email and conference calls.

In keeping with federal, state and local laws, Cambridge Health Alliance (CHA) policy forbids employees and associates to discriminate against anyone based on race, religion, color, gender, age, marital status, national origin, sexual orientation, gender identity, veteran status, disability or any other characteristic protected by law. We are committed to establishing and maintaining a workplace free of discrimination. We are fully committed to equal employment opportunity. We will not tolerate unlawful discrimination in the recruitment, hiring, termination, promotion, salary treatment or any other condition of employment or career development. Furthermore, we will not tolerate the use of discriminatory slurs, or other remarks, jokes or conduct, that in the judgment of CHA, encourage or permit an offensive or hostile work environment.