What are the responsibilities and job description for the Payment Specialist - Corporate position at Integrated Medical Services, Inc.?
ESSENTIAL FUNCTIONS
Essential functions are those tasks, duties and responsibilities that comprise the means of accomplishing the job’s purpose and objectives. Essential functions are critical or fundamental to the performance of the job. They are the major functions for which the person in the job is held accountable. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
NONESSENTIAL FUNCTIONS
- Reconcile all Wells Fargo (or other designated bank account) payments received by confirming deposits in the EHR.
- Uploading all missing remittance to EHR for review and posting.
- Work assigned payment posting buckets in claim worklist
- Assist correcting any payment posting errors as requested by other team members and/or management
- Responsible for identifying, reviewing and processing insurance and patient credit balances when applicable.
- Analyze EOB information, including co-pays, deductibles, co-insurance, contractual adjustments, denials and more to verify accuracy of patient balances.
- Investigate the source of unidentified payments to ensure they are applied to appropriate accounts. If necessary, will contact the sender to clarify where the payment should be posted.
- Reconcile shortage on both paper and electronic EOB's to determine proper allowance and correct write off.
- Assist in performing comparison of downloaded files to the Direct Deposit and correct any discrepancies within bank portal.
- Assist in setting up and updating Electronic Remittance Advice (ERA) and/or EFT for all payers.
- Assist in running insurance credit card payments and posting remittance to the EHR.
- Send all batch reconciliation information to the Finance department as necessary.
- Report any bank discrepancies to Finance department an/or VP of Revenue Cycle within 24 hours.
- Contact patients insurance or third-party administrators when clarification of information is needed to successfully post payments.
- Handle telephone questions and concerns from customers: ensure complaints and inquiries are recorded and reported to management.
- Report all Federal Register (i.e., Medicare, Tricare) credits quarterly to the requesting insurance with the appropriate form and supplies all supporting documentation.
- Work on recoupment accounts to settle and forward balances.
- Research inquiries in a professional courteous manner and work with Accounts Receivable team member to identify and resolve escalated customer concerns within 72 hours, potentially without direct Supervisor oversight.
- Runs reports on outstanding patient/self-pay A/R on a weekly b/monthly basis.
- Manages payment plans that have defaulted.
- Makes telephone or letter contact with all patients with balances more than 45 days old with no payment.
- Contact patients regarding outstanding balances as designated by management and collect and post payments to their account.
- Monitor collection agency report of payment on a regular basis to make sure payment posting in the EHR is current.
- Scan and upload payer correspondence to the EHR.
- Assist with sending W-9 to payers as requested.
- Assist with bankruptcy notices and notify third party collection agency accordingly.
- Perform other duties as assigned to support IMS Mission, Vision and Values.
- Able to communicate, discuss, and dispute credit balances with patient payers.
- Assist with a variety of projects and performs other duties as assigned.
MINIMUM JOB REQUITREMENTS
- High School diploma or equivalent.
- AA degree in any field preferred.
- 2-4 years minimum related health care experience desired
- High developed communication and organizational skills
- Experience assessing problems & implementing solutions
- Must have experience reading and understanding payer remittance advices, Includes the ability to differentiate between allowed charges, contractual adjustments, line-item denials/reasons, patient responsibility (co-pay, co-insurance and deductibles) bundled payments etc.
- Requires both speed and accuracy in performing data entry.
- Requires the ability to organize and prioritize day-to-day tasks to keep work assignment current
- Prefer candidates that are proficient in utilizing MS-Excel for analyzing data using basic formulas, pivot tables and charts.
- Exceptional oral and written communication skills.
- Excellent organizational skills.
- Demonstrated ability to interact effectively with peers and subordinates of all levels.
- Computer skills in the Microsoft environment Outlook, Word, Excel.
- Demonstrated experience in Practice Management Systems.
- Contributes to team effort by accomplishing related results as needed
- The ability to work in a constant state of alertness and in a safe manner.
Experience
Preferred- Experience assessing problem & implementing solutions
- Highly developed communication and organizational skills
- 2-4 years minimum related health care experience
Education
Preferred- High School or better
- Associates or better
Behaviors
Preferred- Team Player: Works well as a member of a group
- Functional Expert: Considered a thought leader on a subject
- Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well
