Payment Specialist

Overview of Positions:

Provides the necessary functions to post all payments in a timely and appropriate manner.

Qualifications:

High School diploma or GED, Associate degree/certification preferred, 1-2 years-experience in health insurance and/or healthcare industry knowledge is required.

Knowledge/Skills:

Good oral and written skills, excellent computer skills, knowledge of insurance industry and medical terminology. Detailed oriented with strong organizational skills. Ability to be flexible with changing priorities, work volume, procedures, and variety of tasks.

Essential Job Functions:

• Accurately process ERA files by importing Electronic Remittance Advice daily.
• Retrieve Explanations of Benefits from payer websites when required to post payment.
• Complete the posting of all payments and non-payments daily.
• Work with payers for missing documentation needed in order to post payments within established lag time.
• Cross train to provide support to other Payment Specialist(s).
• Reconcile payments with clearinghouse or other sources.
• Escalate payer specific ERAs that are not posting correctly.
• Process incoming correspondence.
• Other assigned duties.

Physical Requirement:

Must possess the ability to communicate in the dominant language of the geographic region. Must be able to lift 30 pounds. Vision and hearing corrected within normal limits is required. Must have manual dexterity to key in data, grab, grip, hold, tear, cut, sort, and reach.