Payment Application Specialist

Responsible Duties

• Processes electronic remittances initiating transaction posting in Epic.
• Works transactions that do not post correctly to ensure they route to the appropriate accounts.
• Identifies any unidentified payment transactions that route to the clearing account and follows facility processes to move non-patient money to the correct general ledger account.
• Balances postings to bank deposits utilizing provided technical tools in Epic and via Microsoft Excel.
• Maintains timely and accurate posting according to departmental goals and reports to management.
• Documents accounts clearly and accurately.
• Analyzes and reconciles posting amounts from patient payment and other sources of payment (non-accounts receivable (AR) cash) to the patient accounting system and accounting department.
• Uses system software, including online credit card systems and the Epic system.
• Creates, enters, and assigns cash management batches.
• Opens and distributes mail received from the post office and financial institutions for the various entities services are billed for.
• Contacts the appropriate third party payors, business entities, or financial institutions to resolve unidentified or missing payments.
• Accesses any scanned information via One Content imaging system.
• Completes and reconciles bank deposits daily.
• Utilizes remittance work queues to resolve payment errors.
• Reviews and reconciles all postings monthly with the Departmental Coordinator as needed.
• Participates in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth.
• Researches accounts in work queues with credit or undistributed self-pay balances and works to resolve these balances by distributing to other outstanding accounts, refunding another approved facility, or refunding the guarantor.
• Investigates insurance overpayments and takes appropriate action from within the work queue to resolve the variance.
• Processes refund requests received from third party payors, clinical departments, other areas of Revenue Cycle, and leadership.
• Maintains current knowledge of payor payment provisions and all local, state, and federal collection laws.
• Contacts insurance company or employer to determine eligibility, benefits, and payment information necessary to refund or distribute payments.
• Accurately utilizes payor portals to initiate overpayment recoveries.
• Identifies missing charges and communicates with appropriate coding manager for re-entry.
• Completes reports assigned by Revenue Cycle leadership for bulk refunds to third party payors.
• Monitors work queue for inappropriate hospital payments posted to professional billing and works with appropriate entities for posting.
• Aids accounting department in reconciling patient payments for the entity in which the receipt was deposited.

Qualifications

• High School Graduate or equivalent.
• One (1) year medical billing/medical office experience preferred.
• Bookkeeping and cash balancing experience.