Payment Application Specialist

Role Overview

• Responsible for posting insurance and/or patient payments to Epic and balancing those postings to the bank deposits in a timely and accurate manner
• Assists Departmental Coordinator in researching and resolving outstanding deposits and unidentified or missing payments
• Processes electronic remittances initiating transaction posting in Epic
• Works transactions that do not post correctly to ensure that transactions route to the appropriate accounts
• Identifies any unidentified payment transactions that route to the clearing account, following facility processes to move non-patient money to correct general ledger account
• Balances postings to bank deposits utilizing provided technical tools in Epic and via Microsoft Excel
• Maintains timely and accurate posting according to departmental goals and report to management
• Documents accounts clearly and accurately
• Analyzes and reconciles posting amounts from patient payment and other sources of payment (non-accounts receivable (AR) cash) to the patient accounting system and accounting department
• Uses system software, including online credit card systems and the Epic system
• Creates, enters, and assigns cash management batches
• Opens and distributes mail received from the post office and financial institutions for the various entities services are billed for
• Contacts the appropriate third party payors, business entities, or financial institutions to resolve unidentified or missing payments
• Accesses any scanned information via One Content imaging system
• Completes and reconciles bank deposits daily
• Utilizes remittance work queues to resolve payment errors
• Reviews and reconciles all postings monthly with the Departmental Coordinator as needed
• Participates in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth
• Researches accounts in work queues with credit or undistributed self-pay balances, and works to resolve these balances by distributing to other outstanding account, refunding another approved facility, or refunding the guarantor
• Investigates insurance overpayments and takes appropriate action from within the work queue to resolve the variance
• Processes refund requests received from third party payors, clinical departments, other areas of Revenue Cycle, and leadership
• Monitors accounts that fall within out special billing guidelines (i.e. cosmetic, bariatric, IVF, plastics, etc.) to insure pre-payment application is done within a timely manner
• Works with the appropriate accountants to maintain a list of all unclaimed property, and maintain a spreadsheet for submission to the state
• Takes calls from registration and customer service staff experiencing issues with cash drawers, and works to resolve the issues
• Insures all refund requests are received from accounts payable, and processes the checks for submission to third party or guarantor
• Maintains current knowledge of payor payment provisions and all local, state, and federal collection laws
• Contacts insurance company or employer to determine eligibility, benefits, and payment information necessary to refund or distribute payments
• Ability to accurately utilize payor portals to initiate overpayment recoveries
• Identifies missing charges and communicates with appropriate coding manager for re-entry
• Completes reports assigned by Revenue Cycle leadership for bulk refunds to third party payors
• Monitors work queue for inappropriate hospital payments posted to professional billing, and works with appropriate entity for posting
• Assists hospital cashier’s office in locating and resolving missing receipts
• Aids accounting department in reconciling patient payments for the entity in which the receipt was deposited

Requirements

• High School Graduate or equivalent
• One (1) year medical billing/medical office experience preferred
• Bookkeeping and cash balancing experience
• Excellent oral and written communication skills
• Knowledge of medical terminology preferred
• Knowledge of third party payers preferred
• Knowledge of business math preferred
• Knowledge of ICD-10 and CPT coding processes preferred
• Working knowledge of computers

Benefits

• Health insurance
• Paid time off
• Professional development opportunities