Primary Functions
1. Payment Processing & Posting
Post payments from insurance companies government programs (Medicare/Medicaid) and
patients into the RCM system.
Process Electronic Remittance Advices (ERA) andManualExplanation of Benefits (EOB).
Apply necessary adjustments refunds and write-offs per payer guidelines.
Balance and reconcile daily deposits with posted payments.
2. Denial Management & Reconciliation
Identifyand post insurance denials while ensuringtimelyfollow-up for resolution.
Work with the billing and accounts receivable teams to correct claim errors and resubmit
claims.
Track underpayments and escalate discrepancies to the RCM Manager.
3. Reporting & Documentation
Maintainaccuratepayment records and reconciliation reports.
Generate daily weekly and monthly reports on payment trends denials and discrepancies.
Ensure compliance with company policies and industry regulations (HIPAA Medicare
guidelines).
4. Communication & Collaboration
Coordinate with the billing team accounts receivable and insurance companies to resolve
Paymentdiscrepancies.
Respond to inquiries from internal teamsregardingposted payments.
Escalate unresolved payment issues to theappropriate leadership.
Required Experience:
IC
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