Accounts Receivable Professional Payment Specialist

Job Summary: 

The Accounts Receivable Professional Payment Specialist is responsible for obtaining, preparing, posting, reconciling, adjusting accounts and documenting Professional payments. The position will require the ability to problem solve and work closely with ambulatory sites and practices from registration to accounting to ensure accurate payment postings professional payments. Reconciliation practices and accurate communication and documentation are key elements to this position.

Duties and Responsibilities: 

Responsible for posting insurance and patient payments into all professional billing systems, posting insurance denials into all professional billing systems, appropriately processing insurance and patient refunds in a timely manner.

Daily balances all payments entered into the professional billing systems.

Utilizes balancing procedures to prepare and maintain monthly spreadsheets to provide reporting to Finance Departments.

Follows strict guidelines established by CNE when taking contractual adjustments off of gross charges, or writing off a charge or portion of a charge to bad debt

Verifies the accuracy of deposits made by other departments obtained for professional payments. Take appropriate action if deposit is not accurate when applicable.

Following established guidelines, utilizes the information system tools to provide an audit trail on each patient account through editing, adding insurance demographics, linking appropriate insurance demographics to charges and etc.

Work closely with the Accounting Department to ensure G/L accounts are accurate. Assist with month end reconciliation of G/L entries or deposits when applicable.

Work account credits and properly document patient accounts with supporting documentation when needed.

Works closely with Accounts Receivable Payment Specialist that post hospital payments to sort out payment overlaps from the various insurance companies for hospital and professional claims.

Works closely with the collectors when addressing payments that are incorrect, to ensure accurate posting of any patient co-payments or deductibles.

Properly handles NSF checks that are returned by the bank, properly updates the patients account and sends appropriate documentation to the patient when applicable.

Reviews outstanding refund checks and work with accounting to issue stop payment with bank when necessary.

Obtain remits via payer sites, edit, review, verify, prepare and reconcile third-party payments to ensure accurate posting. Identify appropriate action to be taken, i.e. financial class changes and posting of co-pays and deductibles.

Reviews and reconciles lock box settlements for accuracy.

Researches lock box issues as needed through to resolution, coordinating with the other facility payment specialists.

Assemble information as needed by the Revenue Cycle.

Performs other related duties as assigned

Requirements: 

High school diploma or GED required.

3 years experience in accounts receivable; experience in a health care environment preferred.

Knowledge of third party payers, medical terminology, word processing, statistical tools, and computer applications is highly desirable.