Payment Posting & Reconciliation Specialist

Description :

Our Mission is to deliver best-in-class ophthalmic and optometric care.

Team members are hired to assist the organization in building a differentiated integrated eye care platform focused on superior patient care delivered through our network of optometrists and ophthalmologists.

Team members are expected to a behavior of professionalism, which includes but is not limited to, acting with integrity and accountability, support our clinicians in all aspects of patient care delivery, support a culture of respect, diversity and inclusion in our organization, and enhance the patient access to primary and specialty eye care.

Our vision is to create an admired healthcare company dedicated to delivering personalized eye care with outstanding patient outcomes.

GENERAL SUMMARY :

The Patient Services Specialist is responsible for the prompt and accurate reconciliation, investigation, and resolution of balance sheet accounts, validating all monies and deposits have been received correctly.

ESSENTIAL DUTIES & RESPONSIBILITIES :

Post all personal, insurance and liability payments from Remittance and EOB's to appropriate accounts with minimum errors.

Apply manual payments and auto payments to accounts for payor types of Medicare, Medicaid and Commercial Insurances.

Analyze EOB information, including co-pays, deductible, co-insurance, contractual adjustments, denials and more to very accuracy of patient balances

Scan all EOB's into system and creates hardcopy file for original EOB's by day.

Add appropriate ANSI denial codes and comments to assure all necessary appeals and post payment follow up can take place.

Investigate the source of unidentified payment to ensure they are applied to appropriate accounts. If necessary will contact the sender to clarify where the payment should be posted.

Reconcile shortage on both paper and electronic EOBs to determine proper allowance and correct write off.

Assist in updating the Direct Deposit Daily.

Assist in performing comparison of downloaded files to the Direct Deposit and correct any discrepancies.

Assist in setting up Electronic Remittance Advices (ERA) for Commercial and Medicare payors.

Assist in running and balancing credit cards daily.

Send all batch reconciliation information to the Finance department.

Assist in performing check deposits and assembling logs daily.

Contact patients, insurance or third party administrators when clarification of information is needed to successfully post payment.

Handle telephone questions and concerns from patients.

Work on recoupment accounts to settle.

Research inquiries in a professional and courteous manner and work with Accounts Receivable team members, to identify and resolve escalated customer concerns in a timely manner, potentially without direct Supervisor oversight.

Perform other duties as assigned.

Requirements :

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