Reimbursement Specialist-Cash Applications

Job Description

Job Description

The Cash Poster is accountable for performing all analytical and financial support functions within the department in accordance with internal Policy and Procedure, internal audit controls, Clean Claims Act, government and payer contract requirements. The responsibility of this role is to ensure that all functions are performed timely, accurately and in adherence to Pentec Health’s compliance program.

This is a hybrid position - will be onsite as needed and for training.

Essential Job Duties :

Cash Posting :

• On a daily basis, the Applications Rep will accurately post cash receipts from 3rd party remittances and Explanations of Benefits (EOB) to the appropriate patient invoices as indicated on the remittance / EOB documents. Cash is to be posted and reconciled within 48 business hours of deposit date.
• Utilize their experience and reimbursement knowledge to make decisions on placement of any invoice balances in excess of the payments received. The outcome of these decisions will result in the RA using the appropriate coding for adjusting all or a portion of the balances as over or understated expected; transferring all or a portion of the balances to patient or secondary payer responsibility; and or determining if credit balances are duplicate or overpayments that must be transferred to a liability account and subsequently refunded to the payer or patient.
• Accurately posting commercial denials per EOB and supporting the posting of denials, as needed, ensuring that denial codes utilized accurately reflect the denial origin as stated on the payer documents.
• Organizes and prepares lockbox deposits for cash posting and distribution to appropriate team on a daily basis.
• Contacts insurance payers for missing remittances when necessary
• Utilizing all available reports, the RA reconciles cash receipts posted to cash reported on deposit by the banking institution on a daily basis and / or per batch, as outlined and established by policy.
• At various intervals the Applications Rep will be presented with AR Adjustments, which are to be accurately posted to the appropriate invoices using the appropriate adjustment code as approved by the Supervisor of Cash Applications or Reimbursement Manager. The Applications Representative will utilize their discretion and experience to identify and communicate any discrepancies to the attention of the Supervisor of Cash applications. All adjustments approved and received within a given month are to be posted to CPR+ before the close of each calendar month.
• Run and review an adjustment report at the end of the month to ensure adjustments are properly posted. Corrects any errors or misstatements as needed.
• Post insurance carrier take-back / recoupment. Tracks and reports subsequent utilization of take-back / recoupment based upon review of reimbursements EOB and compares against any known outstanding liabilities per finance records.
• Accurately and concisely document accounts so that information can be readily understood by others throughout the company.
• Other duties as assigned
• Maintain proficiency in both components of the Quality Assurance program (Quality Score and productivity)

Projects

Ideal Candidate Will Have :

Salary Range : $20-23 / hr

Pentec Health offers  a comprehensive compensation and full benefits package.  A ctual pay will be based on several factors such as qualifications and skills for the role plus geographic location.

Benefits may include but are not limited to medical, dental, vision, 401k match, PTO, paid holidays, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.