About this role
Primary Functions:
- Payment Processing & Posting
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Post payments from insurance companies, government programs (Medicare/Medicaid), and patients into the RCM system.
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Process Electronic Remittance Advices (ERA) and manual Explanation of Benefits (EOB).
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Apply necessary adjustments, refunds, and write-offs per payer guidelines. • Balance and reconcile daily deposits with posted payments.
- Denial Management & Reconciliation
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Identify and post insurance denials while ensuring timely follow-up for resolution. • Work with the billing and accounts receivable teams to correct claim errors and resubmit claims.
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Track underpayments and escalate discrepancies to the RCM Manager.
- Reporting & Documentation
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Maintain accurate payment records and reconciliation reports.
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Generate daily, weekly, and monthly reports on payment trends, denials, and discrepancies.
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Ensure compliance with company policies and industry regulations (HIPAA, Medicare guidelines).
- Communication & Collaboration
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Coordinate with the billing team, accounts receivable, and insurance companies to resolve payment discrepancies.
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Respond to inquiries from internal teams regarding posted payments.
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Escalate unresolved payment issues to the appropriate leadership.
Job Qualifications:
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Bachelor’s degree in accounting, Finance, Business Administration, or a related field (preferred).
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1-3 years of experience in medical billing, payment posting, or revenue cycle management.
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Experience working with RCM software (e.g., EPIC, eClinicalWorks, NextGen, Athenahealth,Kareo or Cerner
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Strong understanding of insurance reimbursement, medical billing, and denial management.
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Proficiency in MS Excel, accounting principles, and payment reconciliation.
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Knowledge of HIPAA regulations and compliance standards.