Payment Reconciliation Expert - Medical Billing

reCLAIM Mission

We reward our staff and encourage team building and professional development. We invest in the stock of our employees and growth is the hallmark of our business model. We want you to enjoy coming to work, and we are looking for long-term employees. reCLAIM Billing Solutions believes in an equal opportunity for each applicant and encourages diversity!

We welcome all who want to join our team!

Position Description

The Payment Reconciliation Expert (PRE) will transfer all the data that is received via ERA (835), paper format, or any other format and post the information into the practice management (PM) software. Accuracy is paramount for the PRE as the information that is entered into the PM will affect how the Accounts Receivable team works the medical claim. The PRE will be asked to understand basic mathematics and to have a general knowledge of the standard X12 claim adjustment reason codes.

Position Responsibilities

1. Correcting postings that may have been posted incorrectly by the automated poster.

2. Reviewing paper payments to ensure that the AR team has verified the deposits.

3. Managing the team posting the paper EOBs and auditing their postings for accuracy.

4. Reviewing the automated poster and posting anything that cannot be posted automatically.

5. Reversing and applying those payments to other claims due to recoupments.

6. Auditing the deposits at the end of the month for the accounts that we have bank access.

7. Ensure that all payments are received and leave no unapplied payment balances by the 5th of each month for month end.

8. Reconciling negative insurance balances with insurance and prompting recoupments after verifying a balance owed.

9. Facilitating the verification of negative patient balances and the payment to patients for negative balances.

10. Maintain and monitor trainings and processes that pertain to the Payment Poster’s position.

11. Navigate insurance, third party and EHR portals to obtain Patient Health Information (PHI), while maintaining HIPAA standards.

Maintain and monitor trainings and processes that pertain to the PR Rep’s position.

Position Requirements

Technical Skills

• 2 years in relevant experience or successful completion of externship through reCLAIM Billing Solutions
• Bachelor’s degree (preferred)
• Spanish speaker (preferred)
• Revenue Cycle Management (RCM) knowledge
• Candidate will need to know the claim cycle and how claim processing works
• Critical thinking and problem-solving skills
• Meticulous at note taking and organized
• Drive to generate results
• Fast learner
• Ability to work in fast-paced environment and maintain a sense of urgency
• Client-centered mentality and passion for customer service
• Strive for continuous improvement and career advancement

We Are Looking for Team Members Who Are

• Organized and detail specific
• Proponents of logic and reason
• Self-starters in achieving goals
• Enthusiastic and hungry for growth
• Team players who also take instruction well
• Proactively seeking work to complete, while meeting company expectations
• Maintain updated knowledge of the healthcare industry and learn the new policies set by insurance companies
• Organized in performing company tasks and executing the goals set by management
• Punctual and prompt to their responsibilities

Compensation & Perks

Medical benefits: reCLAIM offers Anthem PPO & HMO

Dental benefits: Renaissance Dental with PPO network

Vision benefits: Renaissance with VSP Vision Care network

Supplemental coverage: Hospital Indemnity, Accident Expense, and Short-Term Disability Income

Retirement benefits: 401k options available

Other benefits: Catastrophic insurance, PTO accrual 40 hours per year (2,080 worked hours). Sixteen (16) hours of sick time annually.

Pay: $21.00 - $25.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $21 - $25