Payment and Reconciliation Specialist- Hybrid Jacksonville, Florida

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 835 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 area 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.
• Other duties as assigned by leadership.
• 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.
• Maintains productivity and accuracy metrics per department expectations and AEIOU Behavioral Standards

Qualifications

• Education: High school diploma/GED
• Experience: A minimum of two years experience in medical billing and/or cash applications or equivalent experience in a healthcare environment. Prefer previous cash posting experience in a multiple lockbox environment.
• Must be able to communicate effectively with Physicians, patients and the public and be capable of establishing good working relationships with both internal and external customers.

Skills

• Knowledge of revenue cycle processes.
• Knowledge of computer systems.
• Experience with Centricity patient management system preferred.
• Knowledge of policies and procedures with regards to physician billing processes including determining insurance eligibility and coordination of benefits.
• Skill in customer service and an understanding of The CORE code of conduct and culture.
• Skill in using computer programs and Microsoft applications.
• Skill in establishing good working relationships with both internal and external customers.

Abilities

• Ability to examine and interpret insurance documents including but not limited to eligibility responses and explanation of benefits (EOB).
• Ability to prepare postings and reconcile daily receipts.
• Ability to communicate clearly and effectively.
• Ability to type minimum 40 wpm.

Environmental/Working Conditions

• Normal office environment.
• Some travel within community.

Physical/Mental Demands

• Requires sitting and standing associated with a normal office environment.
• Some bending and stretching required.
• Manual dexterity using a calculator and computer keyboard.

Organizational Requirements

HOPCo Mission, Vision, and Values must be read and signed.