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Payment and Reconciliation Specialist
Healthcare Outcomes Performance Co. (HOPCo)Payment and Reconciliation Specialist handling accounts receivable and medical billing tasks. Optimizing productivity and communication in a healthcare management company.
About the role
Key responsibilities & impact- Has an understanding of accounts receivable posting process for medical billing including: charges, payments, and adjustments.
- Posting financial transactions through use of the automated systems and team processes.
- Accurately interprets insurance explanation of benefits to ensure proper posting.
- Retrieves and uploads 835 remittance files into patient account system ensuring file reconciliation including reviewing and posting exception files.
- Participation in optimizing productivity within the area.
- Maintains knowledge of the work area and optimizes use of available technology.
- Researches all information needed to process and complete insurance and/or patient refunds by obtaining information from providers, insurance plans, ancillary services staff and patients.
- Accurately processes insurance and patient refunds requests by demonstrating an advanced understanding of coordination of benefits and eligibility requirements.
- Receives and processes all refunds utilizing insurance contracts and requirements for accuracy.
- Processes and posts refund checks as received into the patient accounting system.
- Establishes and maintains effective communication with physicians, staff and other departments as required.
- Other duties as assigned by leadership.
- Adheres and understands the Business Office rules and regulations in regards to Medicare and HIPAA guidelines.
- Effectively forwards accounts requiring work up or resubmission to the business office staff.
- Maintains productivity and accuracy metrics per department expectations and AEIOU Behavioral Standards.
Requirements
What you’ll need- High school diploma/GED
- A minimum of two years experience in medical billing and/or cash applications or equivalent experience in a healthcare environment
- Prefer previous cash posting experience in a multiple lockbox environment.
- Must be able to communicate effectively with Physicians, patients, and the public and be capable of establishing good working relationships with both internal and external customers.
- Knowledge of revenue cycle processes.
- Knowledge of computer systems.
- Experience with Centricity patient management system preferred.
- Knowledge of policies and procedures with regards to physician billing processes including determining insurance eligibility and coordination of benefits.
Benefits
Comp & perks- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
accounts receivable postingfinancial transactions processinginsurance explanation of benefits interpretation835 remittance file retrievalrefund processingcoordination of benefitseligibility requirementscash applicationsrevenue cycle processesmultiple lockbox experience
Soft Skills
effective communicationrelationship buildingteam collaborationproblem-solvingattention to detailproductivity optimizationcustomer serviceorganizational skillsadaptabilityleadership
Certifications
high school diplomaGED