MAKENZIE WILLIAMS

The Payment Posting team is responsible for posting payments, adjustments, and denials from healthcare third party insurance payers and patient to open patient claims, using multiple practice management systems. The core responsibilities of a Payment Poster Specialist are to accurately and efficiently enter remittance information provided from the insurance carriers. All job functions are required to be completed with a minimum number of errors and are subject to routine quality reviews. Associates must be able to work independently in a fast-paced environment.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Review and interpret explanation of benefits (EOB) from insurance carriers to post appropriate payment and denial codes
• Enter alphabetic, numeric or symbolic data such as denial codes into system, following the format displayed on screen
• Reconcile cash batch supporting department cash control policies and procedures
• Complete batch posting with 98% accuracy
• Identify incomplete information necessary to post remittance, contact supervisor to resolve questions, inconsistencies or missing data
• Learn computer applications as they relate to denial management systems; proficiency in at least 1 of the multiple practice management systems (Epic, IDX, ADS) used by SPi Healthcare
• Other duties as assigned by supervisor or management

Responsible for duties in support of departmental efficiencies which may include: but not limited to performing scheduling, registration, patient pre-admission and admission, reception and discharge functions. Must obtain complete and accurate patient demographic information. Patient Access representatives also must employ proper, compliant patient liability collection techniques before, during & after date of service.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Greeting customers following Conifer Standards of Care, provides world-class customer service, completes full patient registration at date of service, adheres to financial & cash control policies & procedures, thoroughly explains and secures Hospital & patient legal forms (i.e., Advance Directives, Conditions of services, Consent for treatment, Important Message from Medicare, EMTALA, etc.). Scan Protected Health Information, create and file patient information packets/folders for upcoming Hospital services. May also assist with scheduling diagnostic procedures (enters data in scheduling system, provide customer with appointment instructions, other tasks as needed).
• Educates patients about patient financial liabilities, employs proper, compliant patient liability collection techniques before, during & after date of service, performs Hospital cash reconciliation & secured payment entry in adherence to financial & cash control policies & procedures.
• Secures medical necessity checks/verification in accordance to Centers for Medicare & Medicaid services, verifies insurance, benefits, coverage & eligibility, completes assigned registration financial clearance work lists activities, obtains insurance authorizations for scheduled & unscheduled Hospital services, and secures inpatient visit notification to payors. May also assist with scheduling and coordinating post discharge care for patients.