Payment Application Specialist

This is a fully remote position, open to applicants in Virginia, +1 more state.

📋 Description

• Accountable for accurately posting insurance and/or patient payments to Epic and ensuring these postings are balanced with bank deposits in a timely manner.

• Aids the Departmental Coordinator in investigating and resolving outstanding deposits along with unidentified or missing payments.

• Processes electronic remittances, initiating the transaction posting within Epic.

• Addresses transactions that fail to post correctly, ensuring they are routed to the appropriate accounts.

• Identifies any payment transactions that are unclear and routed to the clearing account, following facility procedures to allocate non-patient funds to the correct general ledger account.

• Balances postings to bank deposits using the provided technical tools in Epic and Microsoft Excel.

• Maintains timely and precise postings in alignment with departmental objectives and reports to management.

• Accurately documents accounts for clarity.

• Analyzes and reconciles amounts posted from patient payments and other payment sources (non-accounts receivable (AR) cash) to the patient accounting system and accounting department.

• Utilizes system software, including online credit card systems and the Epic system.

• Creates, enters, and assigns cash management batches.

• Opens and distributes incoming mail from the post office and various financial institutions related to the services billed.

• Contacts appropriate third-party payors, business entities, or financial institutions to rectify unidentified or missing payments.

• Accesses scanned documents through the One Content imaging system.

• Completes and reconciles daily bank deposits.

• Uses remittance work queues to address payment errors.

• Reviews and reconciles all postings monthly with the Departmental Coordinator as necessary.

• Engages in educational programs to fulfill mandatory requirements and personal development needs related to the job.

• Investigates accounts in work queues with credit or undistributed self-pay balances, working to resolve these by redistributing to other outstanding accounts, issuing refunds to approved facilities, or refunding the guarantor.

• Looks into insurance overpayments and takes appropriate measures within the work queue to address discrepancies.

• Processes refund requests received from third-party payors, clinical departments, other areas of Revenue Cycle, and leadership.

• Monitors accounts under special billing guidelines (e.g., cosmetic, bariatric, IVF, plastics, etc.) to ensure pre-payment applications are executed promptly.

• Collaborates with accountants to maintain a record of all unclaimed property and keeps a spreadsheet for submission to the state.

• Handles calls from registration and customer service staff facing issues with cash drawers and works towards resolving these problems.

• Ensures all refund requests are collected from accounts payable and processes checks for submission to third parties or guarantors.

• Keeps up-to-date with payor payment provisions and all local, state, and federal collection laws.

• Contacts insurance companies or employers to ascertain eligibility, benefits, and payment details necessary for issuing refunds or distributing payments.

• Capable of accurately navigating payor portals to initiate overpayment recoveries.

• Identifies missing charges and communicates with the relevant coding manager for re-entry.

• Completes reports assigned by Revenue Cycle leadership for bulk refunds to third-party payors.

• Monitors the work queue for inappropriate hospital payments posted to professional billing and coordinates with the appropriate entity for correction.

• Assists the hospital cashier’s office in locating and addressing missing receipts.

• Supports the accounting department in reconciling patient payments for the respective entity where the receipt was deposited.

⛳️ Requirements

• High School Graduate or equivalent.

• One (1) year of experience in medical billing or medical office preferred.

• Experience in bookkeeping and cash balancing.

• Outstanding oral and written communication skills.

• Preferred knowledge of medical terminology.

• Preferred knowledge of third-party payers.

• Preferred knowledge of business math.

• Preferred knowledge of ICD-10 and CPT coding processes.

• Familiarity with computers is essential.

🏝️ Benefits

• Health insurance.

• Paid time off.

• Opportunities for professional development.