Position Summary Posting of cash receipts, electronic remittances and lockbox receipts on a daily basis to maintain current up to date AR balances, and process necessary adjustments concurrent with payments and/or zero pay remittances.Position Responsibilities/Standards:General
- Attend department, clinic or company meetings as required
- Demonstrate sound judgment by taking appropriate actions regarding questionable findings or concerns
- Consistently work in a positive and cooperative manner with fellow staff members.
- Consistently demonstrate ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary.
- Attend required annual in-service programs.
- Demonstrate knowledge and understanding of all company policies and procedures.
Core Values
- Communication: Verbal and written communications are effective in soliciting and conveying information. Information is clear, concise and timely.
- Beacon Policies: Consistently adheres to OrthoAlliance Policies and Procedures (i.e.: including but not limited to: appropriate cell phone and computer usage, dress code, etc.). Also follows all OSHA and HIPAA regulations.
- Teamwork: Demonstrates teamwork within department and with company contacts. Allows for flexibility in how work is accomplished. Treats others with respect and dignity.
- Initiative: Takes initiative in routine situations and proceeds when appropriate. Learns new processes, procedures and technology as needed. Makes appropriate decisions.
- Patient Care/Customer Service: Responds to patients and coworkers in a friendly and professional manner. Anticipates patient needs, patients always come first.
- Dependability: Consistent pattern of good attendance and punctuality. Employee can be relied upon to meet work schedule and complete duties.
Duties and Responsibilities
- Posting payments, adjustments, denials and rejections for manual insurance checks, patient checks and electronic remittance to the correct facility/patient/line item, by the deadline, with accuracy
- Read and analyze insurance Explanation of Benefits (EOB).
- Read and interpret proper payment (underpayment/overpayment) amounts based on applicable insurance fee schedules.
- Research, analyze, and process patient and insurance overpayments/refunds.
- Research and respond by telephone and/or in writing inquiries regarding payment posting issues and problems.
- Balance daily ERA batches and reports; prepare and distribute reports and statistics.
- Participates in continuing educational activities relative to assigned duties and responsibilities.
- Perform other duties as assigned by management.
Education/Experience Required:
- High school graduate or equivalent
- Medical billing payment posting/refunds experience in a health care organization.
Experience Preferred:
- Experience with electronic health records/practice management system.
- Experience with NextGen
- Understanding of major insurance carriers including, HMOs, PPOs and governmental payers.
- Proficiency in Explanation of Benefits (EOB) and payment posting methodologies and principles.
- Recent experience working accounts including billing, collections, payments, refunds, denials and appeals.
- Strong 10-key/keyboard skills; accurate entry of numerical data.
- Sound judgment, maturity, and an ability to establish good rapport with patients, public, and staff.
- Ability to calmly handle multiple tasks at once, and deal with patients and staff with tact and diplomacy.
Work Environment/Physical Requirements:Position is located inside with moderate noise level, good lighting and even temperatures. Physical requirements for the position include the ability to frequently hear and communicate orally, see up close and at a distance, read and comprehend, stand, sit, walk, reach, handle, and/or feel objects. Maximum unassisted lift = 25 lbs. Average lift less than 10 lbs.