Payment Management Representative II

Job Responsibilities:
  • Accurately and efficiently post payments, adjustments, and post collection payments received from insurance carriers, patients, and collection agencies while utilizing the appropriate fee schedule/policy.
  • Review and interpret explanations of benefits (EOB) from insurance carriers to post appropriate payment and denial codes.
  • Demonstrate knowledge of insurance payer guidelines and internal collection guidelines.
  • Identify incomplete information necessary to post remittance and take the necessary steps to resolve questions, inconsistencies, or missing data.
  • Maintain the confidentiality of patient information in accordance with posting guidelines, company policy & procedure, and HIPAA regulations.
  • Run and analyze balancing report to insure accurate posting.

Required Qualifications:

  • High School Graduate or General Education Degree (GED): Required.
  • 2 plus years of experience in customer service, medical billing or related experience.
  • Experience in healthcare insurance billing, knowledge of third party insurance in regards to plan types (HMO/PPO/POS and Indemnity).
  • Knowledge of CPT, ICD-9, ICD-10 or medical terminology strongly preferred.

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