Billing Specialist - Payment Poster
Community Health Alliance - Transitional Living, TLC · Fairfield, OH · 2 wk ago
Full-time
About the role
The Billing Specialist will manage the billing and accounts receivable functions, ensuring accurate and timely billing and posting of payments.
Responsibilities
- Monitor and track claim status, follow up on unpaid or denied claims and resubmit claims as necessary.
- Reconcile accounts receivable on a regular basis and follow up with clients or insurance companies regarding outstanding balances.
- Post payments received from insurance companies and clients into the billing system accurately.
- Balance all checks to ensure all money has been distributed correctly.
- Make an adjustment to the claims while posting the payments to ensure the balance on the EOB and in the EMR match. Make any sequestration adjustments as needed.
- Responsible for all Contractual obligations write-offs, Contractual Adjustments, etc.
- Look for any discrepancies while posting payments to identify if fee schedules have changed or if new codes are being denied that would need to be escalated to the correct team member to investigate the issue.
- Maintain Bank Log to ensure that all insurance Deposits have been received prior to posting EOBs received in Availity.
- Assign any unpaid claim to the appropriate team member so that they can follow up on them timely.
- Work with the payers when a check or remit is missing.
- Retrieve all 835, and EOB’s and upload them into their appropriate folders.
- Ensure compliance with billing and coding regulations, including HIPAA privacy rules and billing standards set by regulatory agencies.
- Work the no pay report.
- Aid in claim denials.
Qualifications
- High School graduate or equivalent.
- 3 years’ experience in payment posting.
- Certified Professional Biller (CPB) or Certified Professional Coder (CPC) preferred.
- Proven experience with billing in a healthcare setting, including knowledge of medical billing procedures and insurance claim processing.
- Experience in contractual adjustments, sequestration and balancing checks with the bank and posting.
- Familiarity with medical terminology, CPT, ICD and HCPCS coding.
- Proficiency in billing software and electronic medical (EMR) systems.
- Experience with Medicare and Medicaid billing regulations.
- Excellent communication and interpersonal skills to interact effectively with clients, insurance companies and healthcare providers.
- Effective communication skills, both verbal and written.
- Excellent attention to detail and organizational skills.
- Identifies potential problems proactively and utilizes critical thinking and problem-solving skills to find a resolution.
- Maintains confidential information and materials appropriately per agency standards and regulatory requirements.
- Ability to manage relationships with various Insurance payers.
Benefits
We provide a comprehensive benefits package designed to support you and your family. This includes:
- Affordable medical, dental and vision insurance
- Company paid Health Reimbursement Arrangement (HRA)
- Generous paid time off (PTO) & paid holidays
- Roth Retirement plan with company match – up to 6%
- Company paid life insurance
- Mileage reimbursement
- A collaborative and mission driven culture
- Opportunities for professional growth and development
- Employee training and continued education opportunities
Pay
Details about pay are not specified in this posting.
Schedule
This is a hybrid position that requires 90 days of in-office training. After successful completion of training, eligibility to work a hybrid remote/in-office schedule is provided.