Payment Processing Specialist - 994374

Primary Purpose

Posts and reconciles payments received from patients, insurance companies, and other sources. Ensures that payments are applied correctly to patient accounts, manages discrepancies, and maintains detailed records of financial transactions.

Job Category

Non-Exempt

Hiring Range

Pay Basis: Hourly

Subject to Grant Funding?

No

Essential Job Functions

• Posts payments and adjustments to patient accounts, including insurance payments, patient co-pays, and other financial transactions.
• Verifies and matches payments with open claims, ensuring that all claims are properly adjudicated, and payment amounts are accurately reflected.
• Maintains detailed records of all payment transactions, adjustments, and reconciliations.
• Ensures that all documentation is complete and accessible for audit purposes.
• Identifies and addresses discrepancies or errors in payment postings.
• Generates and reviews reports related to payment posting and reconciliation activities.
• Provides updates to management on any issues or trends observed.
• Ensures that all payment posting activities comply with healthcare regulations, payer guidelines, and company policies.
• Maintains confidentiality of patient information in accordance with HIPAA guidelines.
• Affords assistance in identifying and implementing process improvements to enhance the efficiency and accuracy of payment posting procedures.
• Performs other duties as assigned.
• Completes special projects as assigned.

Required Knowledge, Skills & Abilities

• Knowledge: Proficient knowledge of MS Office Suite (Outlook, Word and Excel).
• English Language - General knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
• Customer and Personal Service - General knowledge of principles and processes for providing customer and personal services. This includes needs assessment, meeting quality standards for services, and evaluation of user satisfaction.
• Knowledge of payer policies and regulations, including Medicare, Medicaid, and private insurance guidelines.

Skills

• Active Listening - Proficient skills in giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
• Speaking - Advanced skills in talking to others to convey information effectively.
• Critical Thinking - Proficient skills in using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.
• Reading Comprehension - Advanced understanding of written sentences and paragraphs in work-related documents.
• Judgment and Decision Making - Proficient skills in considering the relative costs and benefits of potential actions to choose the appropriate one.
• Writing - Advanced skills in communicating effectively in writing as appropriate for the needs of the audience.
• Complex Problem Solving - Proficient skills in identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
• Service Orientation - Proficient skills in actively looking for ways to help people.
• Communication - Excellent verbal and written communication skills, with the ability to create engaging content.

Abilities

• Problem Sensitivity - The ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.
• Deductive Reasoning - The ability to apply general rules to specific problems to produce answers that make sense.
• Inductive Reasoning - The ability to combine pieces of information to form general rules or conclusions (including finding a relationship among seemingly unrelated events).
• Collaboration - Ability to work effectively with colleagues and supervisors.
• Ability to enter and verify information with accuracy.
• Ability to maintain confidential information.
• Ability to accurately handle financial transactions and reconciling accounts.

Required Education

High School Diploma or Equivalent

Required Experience

• High School Diploma and five (5) years of medical accounts receivable, medical payment posting process including manual and electronic, or insurance payment remittance process experience.
• Associate’s degree and three (3) years of medical accounts receivable, medical payment posting process including manual and electronic, or insurance payment remittance process experience.

Preferred Qualifications

• Experience working with claims management software and electronic health records (EHR) systems, such as Epic, NextGen, or similar.

Is this a safety sensitive position?

No

Background Screening Required?

Yes

Pre-Employment Conditions

Sensitivity Disclaimer: Nova Southeastern University is in full compliance with the Americans with Disabilities Act (ADA) and does not discriminate with regard to applicants or employees with disabilities and will make reasonable accommodation when necessary. NSU is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status or any other legally protected status.