Payment and Reconciliation Specialist

Job Description

Job Description

Center for Bone & Joint Surgery of the Palm Beaches is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each with a specific area of expertise.

Center for Bone & Joint Surgery of the Palm Beaches offers a team approach to your care and provides a variety of services right on campus designed for your convenience and ensuring an outstanding continuum of care. These include on-site X-ray, on-site MRI, on-site physical therapy, and aquatic therapy.

As Center for Bone & Joint Surgery of the Palm Beaches continues to grow, we are looking for a Payment and Reconciliation Specialist. Please see below for the functions and requirements for this position.

ESSENTIAL FUNCTIONS

• Has an understanding of accounts receivable posting process for medical billing including: charges, payments and adjustments.
• Posting financial transactions through use of the automated systems and team processes.
• Accurately interprets insurance explanation of benefits to ensure proper posting.
• Retrieves and uploads remittance files into patient account system ensuring file reconciliation including reviewing and posting exception files.
• Participation in optimizing productivity within area.
• Maintains knowledge of the work and optimizes use of available technology.
• Researches all information needed to process and complete insurance and/or patient refunds by obtaining information from providers, insurance plans, ancillary services staff and patients.
• Accurately processes insurance and patient refunds requests by demonstrating an advanced understanding of coordination of benefits and eligibility requirements.
• Receives and processes all refunds utilizing insurance contracts and requirements for accuracy.
• Processes and posts refund checks as received into the patient accounting system.
• Establishes and maintains effective communication with physicians, staff and other departments as required.
• Accepts and completes additional requests from the Cash Applications Supervisor.
• Adheres and understands the Business Office rules and regulations in regards to Medicare and HIPAA guidelines.
• Effectively forwards accounts requiring work up or resubmission to the business office staff.
• Generate and send patient statements.
• Handle patient billing inquiries in a courteous and professional manner.
• Set up and manage payment plans when necessary.
• Provide reports and updates to billing manager or administrator
• Stay up to date on payer policies, coding changes, and billing regulations
• Follow up on unpaid or denied claims promptly.
• Submit corrected claims and appeals as needed.

At Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:

• Competitive Health & Welfare Benefits
• Monthly $43 stipend to use toward ancillary benefits
• HSA with qualifying HDHP plans with company match
• 401k plan with company match
• Employee Assistance Program that is available 24/7 to provide support
• Paid Time Off
• Holidays
• and more...

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