Processor, Third Party Payment

Summary

Responsible for applying payments received on third party claims against outstanding receivables and coordinating functions of Third Party Payment Processor team.

Pay And Pay Class

Pay Class: Full Time

Pay: $14.54- $18.19 per hour

Essential Responsibilities

• Identify claim correspondence and payment information from Company lockboxes and apply payments received on claims against outstanding receivables by analyzing and understanding Explanation of Benefits documents (EOBs).
• Analyze payments and claims to identify potential issues with plan setup in system or other errors in payment posting.
• Runs daily reports to create and assign work appropriately to payment processors.
• Assist third party claims processors and leads in responding to provider inquiries of incorrect payments, researching discrepancies and generating reports of discrepancies for supervisor.
• Review and research unapplied payments and apply to outstanding claims.
• Coordinate and monitor payment processing by all team members to ensure timely and accurate posting to outstanding claims and ensure compliance by all team members with company policies and procedures.
• Other duties as assigned by supervisors including providing support to Third Party Payment Processor team members and identification of issues, research and development of new procedures.
• Keep Supervisor and Manager updated daily progress and on cash posting issues that arise.
  
  

Education

• High School Diploma, GED, or equivalent work experience
  
  

Experience & Background

• Three (3) plus years of team lead experience in medical insurance claim billing preferred
• Three (3) to five (5) years of prior Cash Posting experience.
• Experienced in MS Excel and Word
• 10- Key by touch (numeric)
  
  

Language Skills

• Well-developed verbal, listening and phone communication skills
• Good written communication skills with the ability to write routine correspondence
  
  

Mathematical Skills

• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
  
  

Reasoning Ability

• Ability to define problems, collect data, establish facts, and identify trends.
• Ability to exercise good judgment and escalate issues appropriately
  
  

Physical Demands/Work Environment

The physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the associate is frequently required to sit, use hands to finger, handle or feel, and talk or hear. The associate is frequently required to stand, walk, and reach with hands and arms. The associate must frequently lift and/or move up to 20 pounds. Required repetitive motion of sitting and using hands to finger and feel. The noise level in this location is moderate (use of computers, printers and machines).

Activity

Amount of Time

None

Under 1/3

1/3 to 2/3

Over 2/3

Stand

x

Walk

x

Sit

x

Use hands to finger, handle, or feel

x

Reach with Hands and Arms

x

Climb or balance

x

Stoop, kneel, crouch, or crawl

x

Talk or hear

x

Close Vision (clear vision at 20” or less)

x

Behavioral Characteristics

• Strong organizational skills and ability to execute manual detailed tasks
• Strong customer service focus and commitment.
• Ability to establish and maintain effective working relationships within the team.
• Ability to get along with diverse personalities; tactful, mature and flexible.
• Work in fast pace environment with interruptions and deadlines
  
  

HIPAA Requirements

All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures.

Visionworks is an equal opportunity employer, committed to the hiring, advancement and fair treatment of individuals without regard to race, color, religion, sex, sexual preference, age, national origin, ethnicity, disability or veteran status, or any other protected status designated by federal, state or local law.

The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria considered necessary to perform the job successfully. As required by changing business needs, complete additional responsibilities as assigned.

Compensation range for the roles is listed below. Applicable salary rangers may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses, equity, and commissions. Pay Class: Pay: $14.12- $17.66 per hour.