Payment Poster and Claims Processing Specialist

Payment Posting and Claims Processing Specialist is primarily responsible for client revenue support throughout the revenue cycle, to include but not limited to: Claim scrubbing and submission, denial management, and insurance payments ---------- sential Duties: May be required to do one or all of the following dependent on the business needs (including but not limited to):
• Assists with the billing process through the claim scrubbing, preparation, and submission to the clearinghouse of accurate and complete claims in a timely manner.
• Completion of denial logs.
• Posting of remittance advices (paper and ERAs)
• Reviews and interprets explanation of benefits (EOB) from insurance carriers to post appropriate payment and denial codes.
• Completes tasks accurately while maintaining quality and production standards
• Posts payments and adjustments from remittance advices, insurance carriers, and electronic downloads while utilizing the appropriate fee schedule/policy.
• Enters alphabetic, numeric, or symbolic data such as denial codes and rejections from all payers into Kareo.
• Demonstrates knowledge of insurance payer guidelines and internal collection guidelines
• Ensures claims get sent to secondary and tertiary payers.
• Inputs zero payment vouchers and insurance rejections from all payer sources in a timely manner
• Identifies incomplete information necessary to post remittance and contact the necessary supervisor to resolve questions, inconsistencies, or missing data
• Meets monthly deadlines
• Assists staff with payment and adjustment questions
• Assists staff with claim scrubbing issues and records issues in the appropriate task logs
• Assists staff with the insurance file updates and access to insurance websites
• Maintains and respects the confidentiality of patient information in accordance with posting guidelines, company policy & procedure, and HIPAA guidelines
• Demonstrates ability to learn computer applications as they relate to job duties and proficiency in the practice management system
• Demonstrates responsibility for professional growth and effective communication
• Other duties as assigned by Supervisor or Manager
Skills and Qualifications:
• Kareo Practice Management Experience preferred
• 3+ years’ experience working with a practice management software and posting payments from insurance companies.
• 3+ years’ physical and occupational therapy billing
• Excellent Microsoft Suite and Google skills.
• Good judgment skills, and capable of making decisions with attention to detail.
• Must have excellent organizational skills and ability to prioritize and coordinate workload with high degree of proficiency.
• Must have excellent data entry skills with a high degree of accuracy.
• Must have excellent analytical and problem-solving skills.
• Ability to work easily and cooperatively with other departments.
• Ability to work independently and follow through on tasks without direct supervision.
• Ability to work well under pressure in a flexible, diplomatic and expeditious manner.
• Maintains strict confidentiality of patients’ medical records and adherence to all HIPAA policies and regulations.