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Payment Posting Specialist

Company: Lags Spine and Sportcare Medical Centers Inc
Location: Visalia
Posted on: August 10, 2019

Job Description:

Description:Job Description: Looking for a well-rounded Payment Posting Specialist. Ideal candidate has a minimum 2 years of experience posting payments/follow up, ICD-10, CPT, HCPCS coding systems, E&M Auditing, as well as a Medical Office Management background. Candidate must have the ability to work toward creating and maintaining good relationships with physicians, supervisors, co-workers, insurance carriers and patients. Additionally, ideal candidate will foster working as a team; dealing with and resolving conflict in a timely, efficient and positive manner and is willing to mentor and train non-billing staff about insurance and billing workflows pertinent to their particular job functions (i.e. front office, collections, eligibility, benefits and authorizations teams, etc). Knowledge, Skills and Abilities:1) Knowledge of payment posting processes2) Knowledge of adjustment codes and denial reasons3) Knowledge of health insurance programs, coverage offered and third-party reimbursement mechanisms, including Medicare, Medi-Cal, PPO, HMO, IPA, PMG, Military and Veteran, Workers Compensation and their billing guidelines and processes4) Knowledge of eligibility, benefits and authorizations processes5) Knowledge of electronic medical record systems6) Knowledge of ICD-10, CPT and HCPCS coding systems7) Knowledge of chart review and documentation auditing8) Knowledge of manual and electronic billing systems and procedures9) Knowledge of appeals and appeals process for different payers10) Knowledge of general office procedures to create efficient and positive work environment11) Skill in communicating effectively to peers, supervisors and patients and to handle stressful situations appropriately12) Audits insurance information for appropriateness in current billing system and is able to quickly identify underpayments or other trends that may negatively affect cash flows13) Ability to read and interpret explanation of payment from different payers14) Ability to prioritize work and able to work with little or no supervision15) Ability to follow up with payers on denials and under payments16) Ability to communicate both verbally and written effectively and efficiently17) Ability to maintain confidentiality of information, most importantly patient financial and medical information18) Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form19) Follows timely filing guidelines per payer to ensure maximum payment20) Ability to understand and respond appropriately, effectively, sensitively to special population groups as defined by race, ethnicity, language, age, sex, etc.21) Ability to hear and speak well enough to converse over telephone Productivity:1) Ensures posting of payments meet standards set by medical corporation2) Uses good judgment when auditing, preparing and billing charges to other entities for payment3) Completion of daily, weekly and added special projects Quality Management:1) Constantly alert for ways to improve customer service, improve patient flow, increase productivity, and improve utilization of resources communicating ideas to supervisor2) Maintains infrequency of denials in the billing process3) Ensures that electronic and paper payments are accurate and completed in a timely manner4) Verifies and ensures competency when utilizing EMR and Billing systems5) Uses mathematical accuracy and attention to detail6) Ensures provider correction requests are responded back to billing in timely manner7) Notifies supervisor of unusual occurrences and adheres to policy regarding incident forms and/or patient complaints8) Attends and actively participates in staff meetings as requested9) Attends and actively participates in staff trainings, webinars and seminars as requested PI112107234

Keywords: Lags Spine and Sportcare Medical Centers Inc, Visalia , Payment Posting Specialist, Other , Visalia, California

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