Payment Reconciliation Specialist

Job Overview
The Payment Reconciliation Specialist is responsible for accurately posting, reconciling, and auditing insurance and patient payments within the medical practice management system. This role ensures that all payments, adjustments, and denials are recorded correctly to maintain the integrity of the accounts receivable (A/R) and support efficient revenue cycle operations.

Key Responsibilities

Payment Posting & Reconciliation

• Accurately post daily insurance payments, patient payments, electronic remittance advice (ERA), and paper EOBs.
• Reconcile deposit reports, bank statements, and payment batches to ensure all payments balance and discrepancies are identified promptly.
• Review and post contractual adjustments, write-offs, refunded payments, and corrected claims as needed.
• Match payments to correct patient accounts and dates of service in the billing system.

Error Resolution & Account Review

• Investigate and resolve payment discrepancies, underpayments, and overpayments.
• Research unidentified or unapplied payments and work with payers or internal departments to obtain clarification.
• Identify payer issues, trends, or denial patterns and escalate to billing management.
• Correct misapplied payments and ensure accounts reflect accurate balances.

Collaboration & Communication

• Coordinate with billing, coding, and authorization departments to resolve claim issues.
• Communicate with insurance companies when clarification or additional documentation is needed.
• Assist front office and patient accounts teams with payment-related questions.

Documentation & Compliance

• Maintain accurate documentation of all posting and reconciliation activities.
• Follow HIPAA regulations and internal financial policies.
• Ensure compliance with payer guidelines, contractual allowances, and proper billing practices.

Qualifications

Education & Experience

• High school diploma or equivalent required.
• Minimum 1–2 years of experience in medical billing, payment posting, or revenue cycle preferred.
• Experience with EOBs, ERAs, CPT/ICD codes, and Athena strongly preferred.

Skills

• Strong attention to detail and high accuracy in data entry.
• Ability to interpret insurance remittances and payment structures.
• Excellent problem-solving and reconciliation skills.
• Proficiency with practice management systems, clearinghouses, and Excel.
• Strong communication and organizational skills.
• Ability to work independently and meet daily deadlines.

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid sick time
• Paid time off
• Retirement plan
• Vision insurance

Work Location: In person