Payment Application Specialist

Job Details

Company Overview:

At Community Eye Care Specialists our mission is to provide our patients with the highest level of quality care and we treat them like members of our family -- because they are. We serve the Northern PA and the Southern NY area with office locations in Warren, Dunkirk, Olean, Seneca, and Jamestown. Our mission is simple as we are helping people see!

Position Summary:

Responsible for daily payment, posting and reconciliation to ensure accurate accounts receivable reporting. Additional duties include reviewing patients case and insurance coverage information to inform patients out of pocket expense.

Responsibilities:

• Posts EOB/ERA, check, credit card and lockbox payments electronically or manually using Practice Management System (PMS).
• Responsible for reviewing patients case and insurance coverage information to inform patients out of pocket expense.
• Review patients scanned requisition record and input all information relating to insurance coverage.
• Take and verify all patients demographic information when registering them for the service or program.
• Identify important patient and demographic information that are missing and inform client about them to avoid claim processing issues with the insurer.
• Establish contact with the ordering physicians office or customer service department to resolve issues concerning missing vital information from patients scanned requisition record.
• Ensure timely processing of benefit information and seek assistance from management when necessary.
• Work cordially in a team and participate in meetings, sharing ideas and information.
• Request pre-certification and benefits on all patients for surgery.
• Balances payment batches against daily deposits.
• Independently evaluates EOB's from third party payers and communicates effectively and timely to the collections team and management when a contractual error is noted.
• Determines denial codes used for each transaction that will determine a patient's balance and/or possible patient balance due statement to be processed.
• Researches unidentified payments and/or recoupments to determine correct transaction.
• Maintains high level of productivity through speed and accuracy.
• Contributes to the team effort by completing various tasks/projects as needed.

Qualifications:

• Minimum of one (1) year Payment Posting experience in a multi-location medical practice or health system.
• Knowledge of insurance payers and cash posting guidelines.
• Strong knowledge in analyzing explanation of benefits (EOB's).
• Prior experience with an electronic medical record system required (EHR/EMR)
• Working knowledge of CPT and ICD10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.
• Intermediate mathematical skills.
• Ability to handle sensitive and confidential information in a professional manner.
• Maintains knowledge of coordination of benefits requirements and processes.
• Demonstrated success working in a team environment focused on meeting organization goals and objectives is necessary.
• Self-motivated with strong organizational skills and superior attention to detail.
• Ability to review documents for accuracy and reasonability.
• Ability to work well under pressure.
• Ability to multi-task, set priorities and follow through without direct supervision.
• Effectively communicate with physicians, patients, insurers, colleagues, and staff.
• Intermediate computer skills including Microsoft Office; especially Word, Excel, and PowerPoint.
• Knowledge of policies and procedures to accurately answer questions from internal and external customers.
• Detail oriented and tolerant of frequent interruptions and distractions from patients and staff.
• Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external.
• Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level.
• Team player that develops strong collaborative working relationships with internal partners and can effectively engage and ability to build consensus among cross-functional teams.

Company Benefits:

We offer a competitive benefits package to our employees:

• Medical
• Dental
• Vision
• 401k w/ Match
• HSA/FSA
• Telemedicine
• Generous PTO Package

We also offer the following benefits for FREE:

• Employee Discounts and Perks
• Employee Assistance Program
• Group Life/AD&D
• Short Term Disability Insurance
• Long Term Disability Insurance

EyeSouth Partners is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

 Community Eye Care Specialists

 06/01/2024

 Jamestown,NY