Payment Application & Reconciliation Specialist

Essential Functions

• Understands accounts receivable posting process for medical billing including charges, payments and adjustments.
• Reconciles posting financial transactions through use of the automated systems and team processes.
• Accurately interprets insurance explanation of benefits to ensure proper posting.
• Retrieves and uploads 835 and paper remittance files into patient account system ensuring file reconciliation, including reviewing and matching charges.
• Participates in optimizing productivity within area.
• Maintains knowledge of the work area and optimizes use of available technology.
• Establishes and maintains effective communication with physicians, staff and other departments as required.
• Accepts and completes additional requests from the Cash Applications Supervisor and Management.
• Adheres to and understands the Business Office rules and regulations regarding Medicare and HIPAA guidelines.
• Effectively forwards accounts requiring work up or resubmission to the business office staff.

Education

• High school diploma/GED or equivalent working knowledge preferred.

Experience

• A minimum of two years’ experience in medical billing and/or cash applications or equivalent experience in a healthcare environment.
• Prioritize previous cash posting experience in a multiple lockbox environment.

Knowledge

• Knowledge of revenue cycle processes.
• Knowledge of computer systems.
• Experience with Athena One/Athena Health management system preferred.

Skills

• Customer service.
• Understanding of HOPCo’s code of conduct and culture.
• Using computer programs and Microsoft applications.
• Establishing good working relationships with both internal and external customers.

Abilities

• Examining and interpreting insurance documents including but not limited to eligibility responses and explanation of benefits (EOB).
• Reviewing postings and reconciling daily receipts.
• Communicating clearly and effectively.

Environmental Working Conditions

• Normal office environment when in office.

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 acknowledged and adhered to.
• List additional organization requirements such as training conducted by organization.