Payment Processing Specialist

JOB SUMMARY

The Payment Processing Specialist is responsible for receiving and processing provider insurance payments, insurance adjustments, rejections, patient payments, patient adjustments, resolving credit balances and issuing refunds on behalf of the University of Louisville Physicians.

Responsibilities

JOB RESPONSIBILITIES

• Perform data entry within department systems.
• Enter payments into the appropriate patient accounts that are received through bank lockbox, electronic fund transfers (EFTs), central business office, practice location, via credit card.
• Post payer adjustments and rejections to the appropriate patient accounts.
• Balance and reconcile work to ensure accurate and timely processing of all transactions according to departmental goals and report to management.
• Research and resolve unidentified payments in work queues.
• Research and resolve payment issues made to incorrect Lockbox / Automated Clearing House (ACH).
• Communicate with insurance payers, when necessary, to resolve payment issues.
• Reconcile all payments posted to bank deposit information.
• Responsible for the transfer of necessary funds and supporting documentation with outside vendors.
• Communicate and perform reconciliation with University of Louisville Research Foundation on KY Medicaid funding and posting.
• Create, manage Excel spreadsheets and work with pivot tables.
• Actively work in document management system, OnBase, retrieving and uploading.
• Meet or exceed department quality and productivity benchmarks.
• Collaborate with other Teams and Departments within the organization.
• Resolve patient and payer credit balances.
• Identify accounts that need a refund and prepare all required documentation.
• Maintain knowledge of healthcare industry billing, payment, refund processing, and payer payment provisions.
• Actively participate in continuous process improvement in the payment processing department for quality purposes.
• Participates in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth.
• Adhere to state and federal compliance policies, reimbursement policies and contract compliance.
• Maintain the confidentiality of patient information in accordance with company policy.
• Assist with training Team members as needed.
• Other duties as assigned by management.

Qualifications

EDUCATION & EXPERIENCE

• Minimum High School diploma or equivalent required.
• Some College preferred.
• Minimum of three years experience working in a Healthcare provider billing and payment posting office.

KNOWLEDGE, SKILLS, & ABILITIES

• Proficient computer skills with MS Office (Word, Outlook). Epic Professional Billing (PB) experience preferred.
• Knowledge of healthcare reimbursement, third party payers, medical billing, medical terminology with ability to read and understand explanation of benefits (EOBs).
• Strong business math skills.
• Strong Excel skills.
• Attention to detail and accuracy. Work requires continual attention to detail in data entry of information related to Personal Health Information (PHI).
• Critical thinking and decision-making abilities.
• Cooperative work attitude toward coworkers, management, and outside contacts.
• Strong work ethic, ability to work independently and solve problems associated with assigned duties and effectively multi-task.
• Strong organizational skills to prioritize, organize and completed work to meet deadlines or department objectives.
• Ability to converse and respond to common inquires from peers, supervisors, vendors and patients.
• Ability to write business-related documents such as emails, letters and other business correspondence as needed.
30+ days ago