Location: Sandy Springs, GA - on-site work/no work from home
GENERAL SUMMARY OF DUTIES: Responsible for daily payment posting, posting of zero pays (Profee and RX), allocation of copays (Profee and RX), running copay reports, submitting refunds, submitting transfers, daily balancing, reconciliation to ensure accurate accounts receivable reporting, and all other duties assigned.
SUPERVISION RECEIVED: Reports to Accounts Receivable Manager
SUPERVISION EXERCISED: None.
ESSENTIAL FUNCTIONS:
- Posts daily, corrects, conducts reversals if needed, and applies patient and insurance payments including all bill types and corresponding contractual adjustments to patient accounts.
- Maintains required databases and patient accounts, reports, and files.
- Lists unidentified payments to correct lockbox, documenting transactions to maintain an adequate audit trail and posts received amounts to the lockbox spreadsheet obtained from Wells Fargo.
- Resolves misdirected payments and returns incorrect payments to the sender.
- Copies any zero payments (denial) to the appropriate Patient Account Representative for follow-up and posts appropriately to systems.
- Submits live checks to Wells Fargo bank institution.
- Corrects and posts debit/credit adjustments of misapplied payments to ensure accurate and timely reporting of accounts.
- Answers patient inquiries regarding account balances.
- Sends statements to patients when required.
- Prepares and processes patient and insurance refunds in and from the system.
- Prepares and processes transfers to NSH billing system (STAR).
- Brings system-related issues immediately to management’s attention.
- Brings possible process improvements to management’s attention to discuss/review.
- Participates in online educational classes through ADP.
- Maintains strictest confidentiality.
- Allocation of copays and prepares the deposit bags for NSH.
- Processes and posts any credit card payments received from phone calls or statement information from the patient.
- Maintains a good working relationship with peers, management, and outside vendors used for collection purposes.
- All other duties assigned by management.
EDUCATION: High School Diploma or GED, College Preferred
EXPERIENCE: Minimum two years experience of payment posting within a healthcare organization.
KNOWLEDGE:
- Knowledge of medical terminology, CPT, HCPCS, ICD-10 coding.
- Knowledge of insurance plan regulations and billing requirements for reimbursement.
- Knowledge of insurance claims processing.
- Knowledge of Explanation of Benefits.
- Knowledge of computer programs, MS Excel, Outlook, Word.
- Knowledge of grammar, spelling, and punctuation to type correspondence.
SKILLS:
- Skilled in establishing and maintaining effective working relationships with other employees, patients, and insurance company representatives.
- Skilled in using computer programs and applications, MS Excel, Outlook, Word.
- Skilled in typing at least 40 wpm.
ABILITIES:
- Ability to communicate clearly and effectively with compassion and understanding.
- Ability to work independently.
- Must be able to process patient inquiries.
- Must be able to meet deadlines and work under pressure.
- Must be able to recognize, evaluate, and solve problems.
- Must be able to maintain confidentiality of sensitive matters.
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