CARES , a division of Hanger Orthopedics, is currently seeking a Medical Payments Specialist to join our Phoenix team. The Payments Specialist position is responsible for inputting new claims, processing payments, preparing daily reports for claims management team, and conducting billing research and responding to telephone inquiries.
The Medical Payment Specialist may be assigned to one of the following disciplines:
- Posts payments and ensures allowances, adjustments and write-offs are posted correctly, reconciles electronic remittances (ERA), EFT payments and electronic lockbox transactions.
- Processes charge corrections and ensure balancing, processes refunds, performs check payment reconciliations and completes deposit reports and investigates unidentified cash and resolves misdirected payments.
- Prepares and submits clean claims to various insurance companies either electronically or by paper; reconciles billing and invoices, checks balances, produces statements, and maintains patient files.
- May perform insurance billing clerical work, including reviewing and verifying insurance accounts against program provisions (e.g., Medicare, BlueCross). Resolves routine patient billing inquiries and problems.
- Follows up on all open accounts in a timely manner to ensure that accurate chronological financial records are maintained on each patient; coordinates communications with payers to ensure accurate billing practices, to enhance reimbursement opportunities, and to achieve cash collection targets.
- Apply all cash and adjustments to the computer billing system and make bank deposits in a timely manner. Maintain a system of internal controls to ensure proper handling of cash receipts including data entry and bank deposits.
- Maintaining payer contracts in contract management software to ensure system is applying proper claims reimbursement methodology for accurate payment from both government and commercial payers.
- Inputting new claims, determining eligibility for claims processing; processing payments through both automated and manual information systems, conducting billing research and responding to telephone inquiries.
- Compiling and analyzing contractual allowances in relationship to insurance contracts and government payer arrangements.
- Associates degree or equivalent experience
- 2+ years of experience posting Medical payments.
- Experience with Durable Medical Equipment is a plus
- Detail orientated
- Excellent customer service skills; ability to be diplomatic and tactful
- Strong PC skills