Job Objective :
Under the direction of the Vice President of Revenue Cycle or designee, the Explanation of Benefits (EOB) Reviewer ensures all that all Commercial and Managed Care payments and adjustments are posted correctly, and that the balance is moved to the next payor or underpayment bucket accurately and timely. Post electronic remittance advices and patient payments. Assists the Account Receivable Specialist with other types of posting within the Cash Poster's skill sets and abilities.
Duties and Responsibilities :
A. Electronic Remittance Advice (ERA) Posting
Post ERAs from, but not limited to, Medicare, Medi-Cal, and Blue Cross
C. Other Responsibilities
Document account information at time of posting
D. Others
Verify that all payments and adjustments are posted to correct insurance plan
Knowledge
Working knowledge of HMO, PPO, and Commercial reimbursement
Working knowledge of Managed Care contract language and interpretation
Technical knowledge of all reimbursement methodologies, APC, DRG, Per Diem, etc.
Document account information at time of posting
Abilities
Strong analytical and math skills
Ability to work in a fast-paced team environment, as well as independently
Ability to remain professional and courteous at all times, regales of the situation
Education
High School graduate or equivalent
Experience
Minimum 1-year previous Commercial, HMO and PPO insurance follow-up experience
Previous EOB Reviewer experience, preferred
Reviewer • Hialeah, FL, USA