Payments SpecialistJob Summary: The Payments Specialist is a key member of the billing team responsible for posting payments to patient accounts and applying contractual adjustments in compliance with established guidelines. The specialist ensures accuracy in payment application investigates discrepancies and works to resolve paymentrelated issues. This position requires adherence to the organizations standard operating procedures (SOPs) while handling payments for clients in a timely and efficient manner. Essential Functions May Include: - Accurately and efficiently post payments to patient accounts in accordance with Synergy productivity and quality standards.
- Post contractual adjustments based on remittance advice (RA) or explanation of benefits (EOB) ensuring proper allocation of payments to services provided.
- Apply and review contractual adjustments based on payer contracts and fee schedules ensuring proper documentation and accurate posting in the system.
- Research and resolve any payment discrepancies or issues not covered under standard operating procedures (SOPs).
- Communicate unresolved issues to the Payments Manager for further investigation and resolution.
- Ensure that all payments are processed in accordance with established policies and procedures meeting deadlines and quality standards.
- Remain current on industry regulations payer policies and FQHC billing guidelines to ensure compliance with federal and state regulations.
Education: High School Diploma or GED. Skills/Experience: - At least two years of medical billing experience
- CPC certification preferred
- A background in hospital and/or medical facility preferred
- Knowledge of medical billing/insurance practices
- Knowledge of multiple billing computer software
- Knowledge of business office procedures
- Comprehensive understanding of how to process paper and electronic medical claims
- Ability to operate a computer and basic office equipment
- Ability to establish and maintain effective working relationships with insurance company representatives and colleagues
- Must be well organized and detailoriented
- A positive attitude
- A strong desire to succeed
Environmental/Working Conditions: Normal office environment. Occasional overtime may be required and/or hours may be shortened as business needs dictate. Physical Demands: Requires sitting and standing associated with a normal office environment. Manual dexterity needed for using a calculator and computer keyboard. Synergy Billing is an equal opportunity employer and does not discriminate based on race color creed religion national origin sex marital status age or disability/handicap with respect to recruitment selection placement promotion wages benefits and other terms and conditions of employment.
| Required Experience:
Unclear Seniority