1 Posting/Denial Management Specialist Job in Syosset, NY

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Posting/Denial Management Specialist

Eschen Prosthetic and Orthotics Laboratories

Syosset, NY | Full Time

$52k-66k (estimate)

4 Months Ago

Posting/Denial Management Specialist

$52k-66k (estimate)

Full Time 4 Months Ago

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Eschen Prosthetic and Orthotics Laboratories is Hiring a Posting/Denial Management Specialist Near Syosset, NY

This position will either sit in our Syosset or NYC office located on the upper-east side.
Responsibilities Include but are not limited to:

Payment Posting
Post all payments including check, EFT’s, Recoups and pt credit card/cash payments
Post all hospital payments
Accurately post TPA payments with fee deductions
Accurately posts recoups from carriers and applies forward negative balance to appropriate accounts
Download Medicaid EOP’s from ePaces portal
Investigates insurance carrier overpayments and recoups
Process patient and insurance carrier refunds and submit to AP
Answer patient phone calls related to account balances, refunds and billing inquiries
Escalate patient phone calls when necessary
Review EOP’s when posting manual checks, autoposting EFT’s and $0 payments
Review any balances for patient deductible, coinsurance or secondary carrier and setting correct financial responsibility
Scan EOP’s with patient responsibility balances into PMS
Submit secondary carrier electronic billing claims
Daily Review of the posting log to monitor payments and post within 3 business days of deposit
Ensures payment reconciliation/balancing when posting manually/auto=post
Review posting log for up-to-date reconciliation
Review payor codes are updated in PMS when posting
Report any fee schedule discrepancies to management

Denial Management (excludes follow-up)

Review EOB’s for line item denials
Submit front office discrepancy denials on FO feedback form
Submit corrected claims (modifier issue, demo discrepancy, incorrect POS, NPI) to all carriers and noting the PMS detailing corrections made
Submit reopenings to Medicare and noting the PMS detailing what was submitted

Skills/Requirements:

Strong knowledge of medical insurance, billing guidelines, and compliance.
Knowledge of medical terminology, experience in orthotics and prosthetics preferred.
Practice management software experience highly preferred- Waystar, OPIE, and Medflex experience a plus.
Knowledge of how to navigate NY Medicaid and CT Medicaid portals.
Knowledge of the ePaces portal is highly preferred.
Experience working with billing/AR claims including NY Medicaid.
Demonstrates professional and positive communication with interpersonal skills.
Must be highly detail-oriented with the ability to handle multiple tasks.
High attention to detail and ability to problem solve claim resolution.
Experience in driving process improvement.
Bi-lingual (Spanish), a plus.

Education and Experience:

High school graduate or equivalent required; Associate degree or equivalent preferred.
Experience working in a medical practice/healthcare setting; at least 2 years preferred.