Payment Poster

POSITION SUMMARY

The Payment Poster will be responsible for accurately posting medical insurance payments to patient accounts in an accurate and timely manner. Coordinates activities with stakeholders.

EXPECTATIONS

Every Adelante Healthcare employee will strive to maximize their performance and contribution to Adelante Healthcare and the community we serve every day. Employees are expected to work in a manner that demonstrates a commitment to quality, patient safety, employee engagement, innovation, and the highest standards of personal integrity, professionalism, and competence.

OUR CORE VALUES

• Compassion
• Excellence
• Integrity
• Learning
• Respect
• Sustainability

ESSENTIAL SKILLS AND EXPERIENCE:

• Associates degree preferred
• High school diploma or GED from an accredited institution required

• Excellent working knowledge of insurance carriers’ payment regulations including various reimbursement schemes, coinsurance and deductibles, contractual adjustments, In Network and Out of Network providers
• Knowledge of Medicare, managed care, Medicaid and commercial insurances
• Two (2) years relative payment posting experience in large practice

• CPT4 and ICD10 coding knowledge
• Ability to read and understand explanation of benefits and ANSI/remark codes

• High attention to detail and the ability to multi-task
• Experience with medical and billing software, NextGen preferred and clearinghouses
• Experience with Microsoft Excel and Word
• Excellent organizational skills and interpersonal skills
• Ability to follow directions and meets deadlines
• Excellent time management skills
• 45wmp and 10,000 KSPH
• Valid Level One Fingerprint Clearance Card issued by the Arizona Department of Public Safety for all specialty behavioral health locations

POSITION RESPONSIBILITIES

• Download and remittance advices from clearing house and payer websites
• Manually and electronically posts Explanation of Benefits into practice management system
• Apply payments, adjustments, and denials into practice management system from explanation of benefits
• Ensure payment batches are balanced to deposits
• Identify and corrects balancing issues between remittance advice and batch as well as the deposit
• Reconcile remits to deposits received and posts to practice management once deposit is confirmed
• Ensure all payments, adjustments, and denial transactions are posted timely and accurately
• May assist in securing missing remittance advices
• Apply credits to patient encounters within practice management system

NONESSENTIAL SKILLS AND EXPERIENCE:

• The ability to communicate in more than one language

Additional Duties and Responsibilities

• Other duties as requested or assigned

Patience-Centered Medical Home (PCMH)

All employees are responsible for promoting and participating in interdisciplinary communication and collaboration to enhance the delivery of quality across the health care system. Employees should maintain an environment which supports and engages patients and co-workers in a caring team-based model to promote wellness and improve health outcomes.

Adherence to Compliance and Code of Conduct

All employees are required to comply with Adelante Healthcare’s written standards, including its Compliance Program and Standards of Conduct, policies and procedures and reporting of any conduct that potentially violates Adelante’s legal or compliance requirements. Such compliance will be an element considered as part of the regular performance evaluation.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Physical demands: While performing the duties of this job, the employee may be required to sit for long periods of time, is required to stand, walk, use hands to handle or feel objects, tools or controls; reach with hands and arms; climb steps/stairs; balance; stoop, kneel, crouch or crawl; talk or hear; smell; manage stress as it relates to essential job functions. The employee must frequently lift and/or move up to 25 pounds without assistance and may occasionally be required to lift or move up to 50 pounds with assistance. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

Work environment: While performing the duties of this job, the employee is exposed to weather conditions prevalent at the time when traveling to various clinic sites. The noise level in the work environment is usually moderate. The employee may be subject to health hazards (contagious diseases, blood borne pathogens, etc.) when working in the clinic area.