Claims Posting Specialist

Job Description

REQUIREMENTS

• Ability to identify and resolve problems
• Attention to detail
• Strong analytical skills
• Good understanding of claims processing and resolution
• Knowledge of medical terminology, procedures, billing standards, and data analysis regarding medical billing.
• Ability to establish and maintain a positive and effective work relationship with co-workers, Manager, clients, and members.
• Personal Computer experience.
• Type 45 wpm minimum.
• Ten key 8000 + kph.
• Customer Service experience.
• Good time management skills and the ability to use sound judgment to prioritize work.
• Previous experience in one or more Health Information Systems: Epic physicians or hospital, Meditech, Invision, AS400, Citrix, IDX, Nextgen, Allscript Physicians or hospital, Centricity, Soarian, Series & HBOC Star, Cerner, Practice Plus, TMHP and other Medicaid sites.
• Remote and Hybrid positions require internet connections that meet the Company’s upload and download speed criteria.

RESPONSIBILITIES

• Responsible for reviewing medical claims to determine if payments are posted correctly, buckets are balanced, and ensuring adjustments are posted accurately.
• Pull EOB’s from the website and post them as needed.
• Upload ERA’s to hospital HIS under correct payer.
• Review line items to ensure they paid according to the ERA.
• Add insurance to accounts and correct payment information if it does not match the ERA when appropriate.
• Responsible for notating accounts in the facility health information system as well as updating status in the ARCC as needed according to the facility requirements.
• Ensure ERA and payment in HIS match.
• Thoroughly review claims to ensure there is no missing or incomplete information regarding payments, adjustments, etc.
• Develop a solid understanding of assigned client processes in order to review claims and accounts receivable functions.
• Able to identify client issues consistently and address issues with Manager timely for quick resolution.
• Able to read, analyze, and interpret complex documents
• Request needed payment information as appropriate to assist with claim resolution.
• Must meet all productivity and accuracy standards established for each individual facility.
• Productivity standards will vary from client to client but the expectation is to have less than a 5% error ratio regardless of client.
• Regular and timely attendance.
• Other duties as assigned.

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