The Medical Payment Posting Administrator is responsible for extensive reviewing EOB’s and ensuring that all high volume incoming payments, allowances, adjustments, denials/rejections and etc. are posted accurately and in a timely manner. Reconciles high dollar amount receivables posted according to departmental operational procedures to ensure daily balances of amounts posted. Coordinates, processes, and audits accounts to determine posting errors and takes corrective action to ensure account accuracy and the ability to meet daily/weekly/monthly deadlines.
A minimum of two years of high volume Healthcare/Managed Care cash application experience is preferred in order to ensure success in this role. Strong customer service, as well as written and verbal communication (including telephonic) skills are also vital to this function. Availability to work overtime, as needed, is essential. PC skills are required as well as intermediate to advanced knowledge of MS Excel and Word software applications.
- Prioritizes daily work and assesses backlog situations, making adjustments as needed;
- Reconciles cash/contractual balances, assuring the reliability and accuracy of the daily bank balancing procedures and variances daily
- Identifies, researches, and ensures timely processing of payments and error corrections, ensuring appropriate documentation of payments, allowances, denial, rejections, etc. are recorded on individual accounts;
- Reconciles daily batch posting to actual entry in order to identify and reconcile any discrepancies, ensuring that payment posting functions are accurate and performed on a timely basis;
- Maintains thorough knowledge of third party payment applications, requirements, and regulatory guidelines at the federal, state, and local levels;
- Meets all monthly and year end fiscal closing deadlines as they relate to the cash application process;
- Meets or exceeds departmental productivity standards on a consistent basis;
- Serves as a member of the Cash Posting (Management/Dept/Coding/Data Entry/etc.) Team. Performs duties necessary to ensure the team’s projects/goals are completed.
- Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties. Takes ownership of special projects, researches data and follows through with detailed action plans. Meets or exceeds short and long term goals and objectives as established for the work unit;
- Ensures compliance with all regulatory, company and departmental and HR policies and procedures;
- Maintain strict confidentiality in accordance with HIPAA regulations and Company policy, including divulging any patient private health information (PHI) only on a need-to-know basis to payers requiring the information for claims payment processing.
- Performs other duties as assigned, required or requested.
Qualifications
Associate’s degree (A.A.) or equivalent from a two-year college or technical school; or one-to-two years related experience and/or training; or equivalent combination of education and experience.
The above noted job description is not intended to describe, in detail, the multitude of tasks that may be assigned but rather to give the associate a general sense of the responsibilities and expectations of his/her position. As the nature of business demands change so, too, may the essential functions of this position.