Patient Accounts Receivable (AR) /Payment Posting Clerk plays a crucial role in ensuring accurate and timely recording of payments received from patients, insurance companies, and other third-party payers while participating in a collaborative team environment.
Responsibilities:
- Review and maintain patient AR within pre-set policies and goals.
- Reach out to patients in a kind and professional manner regarding current balances.
- Perform collection processes per current policies and procedures.
- Prepare patient refunds.
- Post Payments: Accurately post payments from insurance companies, patients, and other sources into the practice management system.
- Reconciliation: Reconcile payments received with corresponding invoices or claims to ensure accuracy.
- Identify Issues: Investigate and resolve discrepancies or issues related to payments and posting within the practice management system.
- Documentation: Maintain detailed records of payments posted and ensure documentation is complete and organized.
- Communication: Collaborate with RCM Leadership and Finance Team as needed to support job functions.
- Compliance: Adhere to all relevant regulations, guidelines, and policies related to billing and payment posting.
- Reporting: Retrieve insurance Remittance Advice notices and Explanation of Benefits for proper handling.
- Process refunds as requested for patients and insurance carriers once approved by RCM Leadership.
- Monitor all payment portals (State Medicaid, Zelis, Availity, Payspan, and Optum Pay).
- Monitor all mail correspondence received for the RCM Department.
- Assist with post-submission claims follow-up as needed to support the Denials Team.
- Ensure strict confidentiality of financial records in accordance with HIPAA guidelines.
- Participate in weekly/monthly team meetings.
- Duties and responsibilities may be added, deleted, and/or changed at the discretion of management and through agreement.
Requirements:
- Ability to effectively and compassionately communicate with patients and clients.
- Knowledge of medical billing/collection practices and timely filing guidelines.
- Understanding of EOBs including Remittance Advice Remark (RARC) and Claim Adjustment Reason Codes (CARC).
- Strong understanding of insurance benefits (deductibles, co-insurances, copays, and out-of-pocket expenses).
- Ability to function on multiple practice management programs, as well as other business office machines.
- Knowledge of basic medical coding including CPT and ICD-10-CM coding guidelines.
- Ability to work independently and prioritize projects.
- Ability to work with patients, billing/coding, and clinical staff.
- Must be well-organized and detail-oriented and possess strong team communication skills.
Experience: Must have 1 year experience in collections or medical billing field.
Education: High School Diploma or equivalent.
Mental and Physical Requirements: Must possess physical and mental abilities to perform the tasks normally that are mostly sedentary with occasional standing, walking, reaching. Daily and repetitive data entry may cause nerve problems unless ergonomic techniques are used. Periodic stress occurs from handling many calls and dealing with patient and provider requests.
Conditions: Normal office setting that requires the ability to work under pressure and with a diverse population, including staff, physicians, clients, patients, insurance companies, labs, hospitals, and other members of the public on a regular basis.
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