Payment and Reconciliation Specialist

Essential Functions

• Has an understanding of accounts receivable posting process for medical billing including: charges, payments and adjustments.
• Posting financial transactions through use of the automated systems and team processes.
• Accurately interprets insurance explanation of benefits to ensure proper posting.
• Retrives and uploads remittance files into patient account system ensuring file reconciliation including reviewing and posting exception files.
• Participation in optimizing productivity within area.
• Maintains knowledge of the work and optimizes use of available technology.
• Researches all information needed to process and complete insurance and/or patient refunds by obtaining information from providers, insurance plans, ancillary services staff and patients.
• Accurately processes insurance and patient refunds requests by demonstrating an advanced understanding of coordination of benefits and eligibility requirements.
• Processes and posts refund checks as received into the patient accounting system.
• Establishes and maintains effective communication with physicians, staff and other departments as required.
• Accepts and completes additional requests from the Cash Applications Supervisor.
• Adheres and understands the Business Office rules and regulations in regards to Medicare and HIPAA guidelines.
• Effectively forwards accounts requiring work up or resubmission to the business office staff.
• Generate and send patient statements.
• Handle patient billing inquiries in a courteous and professional manner.
• Set up and manage payment plans when necessary.
• Provide reports and updates to billing manager or administrator.
• Stay up to date on payer policies, coding changes, and billing regulations.
• Follow up on unpaid or denied claims promptly.
• Submit corrected claims and appeals as needed.

Qualifications

• High school diploma or equivalent.
• One year of experience in a medical billing environment preferred.
• Knowledge of medical terminology and coding systems.
• Strong attention to detail and organizational skills.
• Ability to work independently and as part of a team.
• Excellent communication and interpersonal skills.

Benefits

At Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes:

• Competitive Health & Welfare Benefits
• Monthly $43 stipend to use toward ancillary benefits
• HSA with qualifying HDHP plans with company match
• 401k plan with company match
• Employee Assistance Program that is available 24/7 to provide support
• Paid Time Off
• Holidays