Medical Payment Poster & Biller

JOB TITLE:  Medical Payment Poster & Biller                                                         

SUMMARY: The Medical Payment Poster & Biller accurately inputs information into the billing system, processes insurance claims and billing by obtaining background information and making arrangements to obtain monies owed.

DUTIES AND RESPONSIBILITIES:

• Keep track of payment deposits from patients and insurance reconciling details. 
• Ensure proper payment posting based on explanation of benefits (EOB) and bank deposit reconciliation. 
• Verify payments are paid in accordance with fee schedules. 
• Reconcile daily totals reports. 
• Conduct audits for billing cycles.
• Assess EOBs from insurance companies. 
• Maintain all checks and EOBs together by deposit date to ensure batch integrity.  
• Review and identify EOBs with incorrect and/or inconsistent reimbursement.
• Communicate payer trends to supervisors. 
• Keep accurate billing records and report any discrepancies to management. 
• Identifies and resolves billing queries/problems.
• Posts payments and applicable credits to accounts while maintaining balance sheets.
• Research and process refund requests and overpayments.
• Communicates with payees to answer questions and provide additional supporting documentation.
• Prepares letters of appeal to insurance companies if the company refuses to pay contracted claims and/or denies a claim; submits documentation necessary to support claim; resubmits claims with corrections if needed for payment for all insurance payers.
• Answers phones and assists patients with accounts.
• Generates and submits electronic claims and statements at designated intervals; corrects any errors for complete and accurate transmission of data.
• Abides by state collection and credit regulations; interprets and complies with state/federal regulations, laws, and guidelines.
• Performs additional duties including but not limited to copying checks received and recording payment, faxing information as required, generating retroactive authorization requests, and verifying medical eligibility.
• Performs other related duties as assigned by management. 

QUALIFICATIONS: 

• High school diploma or equivalent 
• Excellent written and oral communication skills
• 10-key by touch; keyboarding speed of at least 50 wpm.
• Knowledge of medical billing and coding practices. 
• Proficiency with billing software and electronic health records (EHR) systems. 
• Excellent communication and customer service skills. 
• Ability to reconcile payments and identify discrepancies.
• Understanding of healthcare regulations and billing guidelines. 
• Experience with insurance verification and claims processing.
• Strong organizational and multitasking abilities.

GENERAL EXPECTATIONS:

• Behave in a professional manner and consistently demonstrate and promote the values of respect, honesty, and dignity for the patient, families, and all members of team. 
• Committed to the constant pursuit of excellence and teamwork in improving the care of the patients.
• Be punctual with scheduled work and use time appropriately. 
• Perform duties in a conscientious, cooperative manner. 
• Perform required amount of work in a timely fashion with a minimum of errors.
• Maintain confidentiality and protect the Practice by abiding by laws and principles related to confidentiality; keeps information concerning Practice Operations, patients, and employees confidential. 

PHYSICAL DEMANDS AND WORK ENVIRONMENT: 

Requires sitting and standing associated with a normal office environment. Manual dexterity is needed for using a calculator and computer keyboard. This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, skills and working conditions may change as needs evolve.  

The above is intended to describe the general content of and requirements for the performance of this job.  It is not to be construed as an exhaustive statement of duties, responsibilities or physical requirements.  Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.