The Claims Adjudication Representative is responsible to post payments and 835 remittance files to the Paragon accounts receivables and review associated remittances. Utilize Paragon, Claims Administrator, Horizon Patient Folder, Pathways Contract Management, and Emdeon applications.

Process all 835 remittance files in the Paragon system, and all other related duties.

Post all hard copy payments to the Paragon system. 

Process telephone payment requests.

Accept window payments.

Handle petty cash transactions for patient transportation requests.

Prepare daily bank deposit for all monies received and posted to the system.

Index all scanned payments in the Horizon Patient Folder application.

Review all remittance statements in comparison to the estimated amount due on the specific patient account. Flag accounts with variances which must be forwarded to the A/R management representative, utilize ticklers to do so.

Monitor auto secondary crossovers information on remittance to Paragon payor information, if not matching, alert A/R and EDI team for system updates and required billing.

Post contractual allowances where required.

Satisfy payor in Paragon wherever payment matches expected reimbursement amount.

Monitor PCON reports for payment variances.

Attend required meetings

Assist in training of new and established employees