Job Title: Representative, Payment Posting

Company: Tegria Revenue Cycle Management (Tegria RCM)

Department: Payment Posting

Leader: Supervisor, Payment Posting

FLSA Status: Hourly/Non-Exempt

Work Location: Remote within the U.S.

Travel: No travel required

Compensation: $14.00-$21.50

OVERVIEW

The Payment Posting Representative is responsible for posting (both manually and electronically) a high volume of insurance and patient payments in an accurate and timely manner. Additionally, this position may process credit card payments, and reconcile client direct deposits with electronic remittance programs as well as timely resolution of WQ transactions.

Responsibilities include:

• Review and interpret patient statement, payment information from EOBs, balance, and client contractual terms/agreements and to accurately apply payment and adjustments when necessary
• Posting payments, adjustments, corrections, and denials timely and accurately at department standard.
• Identifying and copying payments and or correspondences needed to bill additional insurance companies to maximize reimbursement.

• Identifying and communicating payment types such as Medicare, Medi-Cal, etc.
• May validate patient payments collected by clinics for prompt posting
• Identifying and communicating crediting and duplicate payments and payments below acceptable negotiated amount.
• Balancing, closing, and recording all batches, and updating and maintaining any logs and spreadsheets used for reconciliations
• Treats all information and data within the scope of the position with complete confidentiality and security and maintains all practices to protect PHI and follow HIPAA guidelines.

• Identify, resolve, and escalate major issues and service failures that may impede success
• Research and resolve unapplied/unidentified cash receipts.
• Identifies any payments not being paid or missing ERA/EOB documentation and communicates this to the appropriate representative.
• Review and interpret over payment requests and determine appropriate next steps
• Reviews the unapplied funds report identifying cash transactions that could not post and Identify credit balances at time of posting and submit refund request for approval

• Processes correspondence denials and acknowledgements as a zero pay with transaction message and remark codes
• Other duties as assigned

QUALIFICATIONS

• High school diploma or equivalent
• 1 year experience in healthcare, revenue cycle, customer/client service

• Ability to interpret Explanation of Benefits (EOB)
• Ability to analyze and interpret financial data.
• Excellent attention to detail with a focus on quality
• Ability to multi-task, establish work priorities, work with interruptions, prioritize needs to meet required timelines and deal effectively with confidential information.
• Ability to think independently and use good judgment for situations which require initiative and innovation to appropriately resolve and escalate issues

• Proven skills of data entry and10-key by touch.
• Effective written and verbal communication skills
• Demonstrated ability to work with numbers quickly and accurately with an understanding of basic accounting techniques.
• Proven PC proficiency in Microsoft Office Suite (Word, Excel, and Outlook)
• Demonstrated service excellence with patients, families, clients, and team member

• Maintain confidentiality of all patient demographic, medical, and financial information, ensuring proper handling and disposal of confidential documents and adherence to HIPAA.

Physical Requirements:

The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Listed below are the physical requirements required while performing the duties of this job.

• The employee is regularly required to: stand; sit; talk; hear; use hands and fingers to operate a computer and telephone keyboard; and reach, stoop and/or kneel to install computer equipment
• The employee must have the specific vision ability to complete close vision requirements due to computer work

• The employee is required to be able to complete light to moderate lifting

Our Commitment to Diversity, Equity, and Inclusion

We welcome and respect the variety of experiences, viewpoints, and cultural backgrounds that everyone brings to our workplace. Tegria RCM makes every effort to promote a workplace where leaders model inclusive behaviors and individuals feel respected, valued, and empowered. Together, we promote and sustain an inclusive workplace where people feel a sense of belonging