Responsible for ensuring proper posting by performing efficient and accurate data entry of payments and adjustments received for medical services into multiple databases in accordance with policies and procedures established by the department.
- Enter payments and adjustments into multiple computer systems within set time frames using assigned payment and disposition codes.
- Post payments, write offs, reversals, refunds and adjustments as required.
- Reconcile patient accounts and transfers appropriate balances to appropriate FSC for secondary billing.
- Post 'zero-payment' explanation of benefits and transfer balance to appropriate FSC.
- Identify rejected claims and forward a copy of the EOB to the appropriate collector for follow up
- Research and prepare refunds for management review and approval.
- Perform batch balancing activities and audit payment batches for errors.
- Identify underpayments and other reimbursement patterns.
- Perform electronic remittance advice process including the upload and reconciliation of EDI file which includes manual posting of payment edits, batch reconciliation and quality control of claims rejections.
- Employee will perform additional duties as assigned.
- Other duties as assigned.
- High school diploma, G.E.D., or equivalent.
- 2 years of experience with medical payment and adjustments posting from both electronic and hard copy format, including balancing of batches.
Knowledge, Skills, and Abilities:
- Strong Excel skills
- E-Clinical Works or Allscripts experience preferred
- Good communication and organizational skills
- Computer literate
- Strong and accurate data entry skills
- Mathematical aptitude with 10-key calculator skills
- Self starter
- Understanding of reimbursement methodology processes