Payment Specialist I

Overview:
HOURLY RATE (DEPENDING ON SKILLS/EXPERIENCE): $22.14 - $29.82
SCOPE: Responsible for review of EOBs, posting and managing account payments both in EPIC and Liberty. Audit posted work to ensure accuracy, appropriate reassignment of patient or secondary balances. Troubleshoot and proactively anticipate any potential issues with payment issues and communicating to appropriate parties' issues/resolutions; as well as assisting others with questions/clarifications. Proficiently navigate payer payment systems and payer websites to locate missing EOBs. Responsible for reviewing and adjusting as needed in Epic WQs (credit), distribute monies as appropriate. Help to identify issues and report to supervisor/manager; for potential workflow improvement, EPIC rules to build or edited, etc.
*HYBRID POSITION*
Responsibilities:

• Review automated payment/adjustments and/or post line-item payments and adjustments from manual EOBs to patient accounts and reconcile / adjudicate fee schedule variances with approved variance adjustments.
• Provide information to RCPAYRSUP to allow the research, re-bill, and/or appeals denied/incorrectly/inconsistently paid claims.
• Identifies consistency in fee schedule allowable differences and communicates up-line for updating.
• Analyze credits on accounts via credit WQs to determine if refunds should be processed, erroneous and need corrections or distribute monies within 48 hours.
• Pull daily bank activity for both EPIC and Liberty (DBAs/Lockbox)
• Perform other various duties/projects as assigned
• Audit accuracy of payments submitted greater than 95%.

Qualifications:
MINIMUM QUALIFICATIONS:

• High school graduate or equivalent required.
• 2 years of experience in Billing in Medical Office / Hospital required.
• 1 year EPIC EMR experience required.
• Certified Medical Reimbursement Specialist CMRS preffered.
• Certified Medical Insurance Specialist CMIS preffered.
Minimum of 1 year payment posting experience in a healthcare setting. Must be familiar with all payer types and payer transaction navigation. Must have good time management skills, verbal and written communication skills, 10-key, word processing and proficient in Microsoft outlook and excel.

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.