Revenue Cycle Specialist Iii - Payment Poster

RESPONSIBILITY:

Primarily responsible for expedient and accurate posting of payments received. Ability to resolve claim issues by utilizing extensive in-depth knowledge of company policies and procedures, medical coding, insurance reimbursement practices, and collection laws. Experience with medical billing and collections, account resolution, and the ability to get claims paid. Demonstrates proficiency with billing system to ensure all functionality is utilized for the utmost efficient processing of claims and related tasks.

POSITION RESPONSIBILITIES:

1. Payment Entry:

• Completes payment entry in a timely and accurate manner including:

• Posts payments to practice management system (live checks within 24 hours, Online Credit Card payments the next business day, EFT deposits within 72 hours)
• Records batch totals with date and initials on payment receipt spreadsheet
• Balances batches and runs transaction reports
• Verifies all EFT deposits and scanned checks have been posted by month end

• Properly communicates and documents payment denials in the practice management system and to the appropriate billing representative in a timely manner.
• Identifies any payments not being paid at the allowed/contracted amount and communicates this to the appropriate billing representative – AR and/or Supervisor.
• Batches patient statements electronically on a weekly basis
• Creates invoices for attorney fees and communicates with physician office upon receipt of payment.
• Post all personal, insurance and liability payments from Remittance and EOB’s to appropriate accounts with minimum errors;
• Apply manual payments and auto payments to accounts for payor types of Medicare, Medicaid and Commercial Insurances;
• Analyze EOB information, including co-pays, deductible, co-insurance, contractual adjustments, denials and more to very accuracy of patient balances;
• Scan all EOB’s into system and creates hardcopy file for original EOB's by day;
• Add appropriate ANSI denial codes and comments to assure all necessary appeals and post payment follow up can take place;
• Investigate the source of unidentified payment to ensure they are applied to appropriate accounts. If necessary will contact the sender to clarify where the payment should be posted;
• Reconcile shortage on both paper and electronic EOBs to determine proper allowance and correct write off;
• Assist in updating the Direct Deposit Daily;
• Assist in performing comparison of downloaded files to the Direct Deposit and correct any
• discrepancies;
• Assist in setting up Electronic Remittance Advices (ERA) for Commercial and Medicare
• payors;
• Assist in running and balancing credit cards daily;
• Send all batch reconciliation information to the Finance department;
• Assist in performing check deposits and assembling logs daily;
• Contact patients, insurance or third party administrators when clarification of information is
• needed to successfully post payment;
• Handle telephone questions and concerns from customers; ensures complaints and inquiries
• are recorded and reported to management;
• Report all Medicare credits quarterly to Medicare on appropriate form and supplies all

supporting documentation;

• Work on recoupment accounts to settle;
• Follow up with outstanding A/R all payers and/or including self-pay and/or including
• resolution of denials;
• Read, analyze, and interpret common scientific or technical information, financial reports
• and legal documents;
• Research inquiries in a professional and courteous manner and work with Accounts Receivable team members, to identify and resolve escalated customer concerns in a timely manner, potentially without direct Supervisor oversight. Partner with Team Lead and Supervisor to develop solutions to repeat customer concerns;
• Act as point of contact for the team when Supervisor/Manager/Team Lead are unavailable;
• Perform other duties as assigned
• Identify accounts that have secondary payer and take the appropriate action to ensure secondary billing is complete.
• Inputs all zero payment vouchers and insurance rejections from all payer sources in a timely manner

2. Department Coverage:

• Cross trained to provide department coverage in charge entry.
• Maintains professional knowledge regarding medical billing and coding procedures, insurance carriers, federal programs, etc.

MINIMAL REQUIREMENTS:

• High School Diploma or equivalent

• Minimum 5+ years’ recent experience with payment posting in a medical billing office/CBO environment with emphasis on high volume and/or multiple accounts.

• Proficiency in CPT codes, ICD-10 codes, HCPC codes and use of modifiers

• Candidates must be able to work with high volume of work while maintaining attention to detail and accuracy and demonstrate excellent oral and written communication skills.
• Computer skills required to operate practice management system (i.e., use Window operating system conduct Internet searches, communicate by email, etc.)
• Ability to organize and manage multiple priorities commitment to company values

• Ability to work independently and with customers and insurance companies in a high-pressure environment while maintaining excellent customer service

• Basic math skills and accurately process money transactions (must be able to read & understand an EOB)

• Experience with office equipment: multi-functional printer/copier/fax, multi-line phone system, calculator, postage machine, and so on

• Must be proficient using the computer, data entry, and have above average typing skills

• Experience with MS Office, EMR/EPM systems

• Experience with eClinical Works Practice Management system preferred

• Prior experience with ENT specialty a plus

• CBO environment a plus

PHYSICAL DEMANDS:

The physical demands and work environment characteristics 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 job functions.

• Physical Demands: While performing the duties of this job, the employee is occasionally required to use hands to finger, handle, or feel objects, tools, or controls; walk; sit; stoop, reach; balance; talk or hear.

• Specific vision abilities required by the job include distance vision, color vision, peripheral vision, close vision, depth perception, and the ability to adjust focus.

• Work Environment: Office environment where the noise level is usually minimal.

*All employees are expected to adhere to all company policies. Job description may be changed at any time.