Revenue Cycle Specialist III

Location: Nashville, TN

Employment Type: Full-Time, M-F hybrid role

Reports to: Director of Revenue Cycle Management

The Cash Poster Specialist is responsible for accurately posting payments, adjustments, and denials to patient accounts in accordance with payer contracts and organizational policies. This role plays a critical part in ensuring accurate account balances, timely reconciliation, and the overall integrity of the revenue cycle.

Responsibilities

• Accurately post insurance payments, patient payments, contractual adjustments, and refunds to patient accounts in a timely manner, ensuring all transactions are applied to the correct encounter, date of service, payer, and provider in accordance with payer contracts and organizational policies.
• Review and interpret Explanation of Benefits (EOBs) and payer correspondence to validate payment amounts, identify contractual allowances, and ensure proper application of payments, adjustments, coinsurance, deductibles, and patient responsibility.
• Identify, analyze, and appropriately route underpayments, overpayments, denials, partial payments, and zero-pay claims to the appropriate teams, documenting findings and attaching supporting payer documentation as needed.
• Reconcile posted payments and adjustments with bank and billing system totals by researching variances, correcting posting errors, and escalating unresolved discrepancies.
• Apply payer-specific contractual adjustments accurately using established fee schedules, contracts, and payer reimbursement guidelines, ensuring compliance with negotiated rates, and identifying variances.
• Process refunds, credit balances, and payment reversals in accordance with internal policies, payer requirements, and regulatory guidelines, including verifying refund eligibility, obtaining required approvals, and documenting actions taken.
• Maintain detailed and accurate documentation of all payment activity, including posting actions, corrections, correspondence, and reconciliation efforts, to support audits, reporting, and internal controls.
• Collaborate closely with billing, denial management, and finance teams to resolve posting issues, clarify payment discrepancies, and support timely resolution of account balances.
• Ensure full compliance with HIPAA, payer guidelines, contractual obligations, and organizational policies when handling protected health information and financial data.
  
  

Qualifications

• 3 to 5 years of experience in medical billing, cash posting, or revenue cycle management.
• Strong proficiency in Microsoft 365 (Outlook, Word, Excel, Teams, etc.), with the ability to quickly adapt to new tools and systems.
• Working knowledge of payer regulations and hospital billing processes.
• Familiarity with CPT, ICD-10, and HCPCS coding concepts.
• Experience using electronic health record (EHR) and/or medical billing software.
• Excellent verbal and written communication skills.
• Exceptionally proactive, organized, and detail oriented.
  
  

This job description is not intended to be an exhaustive list of all job responsibilities or qualifications associated with the position. The Company reserves the right to modify, add, or remove duties, and to assign other responsibilities as necessary to meet business needs, consistent with the employee’s position, qualifications, and applicable law.