November 14, 2024

Down East Community Hospital

Machias

FULL TIME

Billing/Payment Posting Specialist

Description: Billing/Payment Posting Specialist with a strong background in managing accounts receivable billing and collection of payments for all designated payors and locations in order to meet and maintain our goal. In this role, you will manually and electronically process and post a high volume of billing statements while updating account adjustments and keeping records of account standings. Our ideal candidate will have at least two years of experience working in accounts receivables, with remittance processing, or in a similar medical billing or customer service role. To seek reimbursement for hospital patient accounts by accurately billing third party payors and patients and performing follow-up as necessary to secure payment for each patient account.
Requirements:

Associate degree in business or two years related experience

ESSENTIAL JOB FUNCTIONS

Post all ERAs, paper remits and reconcile deposits to postings for all insurance carriers with minimum errors
Analyze EOB information including co-pays, deductibles, co-insurance, contractual adjustments, and denials to verify accuracy of patient balances
Review EOB’s and/or insurance correspondences in order to process or forward claims to the denials team
Identify and communicate discrepancies in payments received
Maintain a documentation of cash transactions and perform a reconciliation of prior day’s daily deposits
Research unidentified payments for proper posting
Update patient accounts to reflect adjustments made
Contact patients, insurance carriers, or third-party administrators when clarification of information is needed to successfully post payments
Maintains professional knowledge regarding medical billing and coding procedures, insurance carriers, etc.
Perform daily edits, submit claims to third party payors, & manage work queues to resolve all AR accounts
Identify & resolve overpayments, late charges, incorrectly posted charges and payments and process credit balance within applicable filing limits
Work with appropriate hospital departments to coordinate the reimbursement process.Seek out needed information by staying informed and involved by attending meetings, reading memos, policies, meeting minutes, newsletters, email and other appropriate information in a timely manner.
Reliable attendance and punctuality, including observing appropriate break times.
Perform duties in a safe manner, in compliance with all safety policies and procedures.
Comply with the Code of Conduct and all appropriate policies and procedures.
Other duties, as assigned, that are relevant to the position and department.

PHYSICAL EFFORT AND ENVIRONMENT
Moderate: Occasionally lifts up to 25 pounds independently. Occasionally pushes/pulls 100 pounds. Stands or walks often.
QUALITY IMPROVEMENT
Maintains current knowledge of the hospital-wide Quality Improvement Program.

Collaborates with management to improve the effectiveness of the department through the Quality Improvement plans and processes.
Participates in the departmental and hospital-wide Quality Improvement activities as directed by the manager.

COMPLIANCE
Adheres to the federal, state, and local statutes and regulations.
Adheres to the Compliance Program policies and procedures of DECH/CCH.
Adheres to all Privacy and Security policies and procedures of DECH/CCH.
Communicates any concern related to compliance issues to manager of department or Compliance Officer.
Communicates any concern related to confidentiality issues to the Privacy Officer.