The purpose of the Payment Posting Associate is to correctly and timely interpret third party payments and apply this information to the Antrim financial system triggering the appropriate departmental work flow process including denial/appeal processing, underpayment recovery as well as the balancing of cash transactions received in the form of electronic remittance files, lock-box and mail deposits.
Correct and edit batches and/or electronic remittance files as assigned by Supervisor to enable timely and accurate posting of third party transactions.
Interpret and post denial transaction codes as defined by the payer and provider organization to ensure the timely and accurate routing of denial follow-up and appeal activities.
Calculate co-insurance and deductible percentages as needed based on the level of detail provided by the third party payer remittance.
Perform research on a routine basis to determine the appropriate posting account for unidentified payments received by the payer or patient which includes, but is not limited to, contacting third party payers and / or patients to inquire on correct payment account.
Perform payment transfer for undistributed Self Pay payments to open self pay accounts.
Collaborate with Accounts Receivable team to investigate the location of a missing payment.
Conduct scanning and indexing functions in conjunction with document storing and balancing procedures.
Respond to third party and patient overpayments by generating refund requests.
Work all claims on exception report.
Additional duties as assigned.
High School diploma or equivalent required; college degree preferred.
At least two (2) years experience in a healthcare accounts receivable environment; working knowledge of healthcare payer Explanation of Benefits preferred.
Demonstrate proficiency in Microsoft Word and Excel. Adhere to Medicare, Medicaid Compliance and HIPAA guidelines in relation to PHI information.
Ability to interpret an Explanation of Benefits.
CBLPath, Inc. - 15 months ago