• Accurately post insurance payments, patient payments, adjustments, and denials to patient accounts using the organization’s billing system.
• Ensure payments are applied correctly according to payer guidelines and patient account information.

Apply contractual adjustments and write-offs based on payer agreements and company policies

Reconcile Payment Discrepancies:

• Identify and investigate payment discrepancies, including overpayments, underpayments, or missing payments.

Work with the billing, coding, and insurance verification teams to resolve discrepancies and ensure proper allocation of payments.

• Insurance Payment Reconciliation: Reconcile payments received from insurance companies to the corresponding Explanation of Benefits (EOBs) or Remittance Advices (RAs).                                                                                                                                      Review and analyze EOBs for any denials, underpayments, or payment issues and address them accordingly.
• Patient Payment Posting: Post patient payments received via check, credit card, cash, or electronic payments to their respective accounts. Ensure patient payments are applied correctly, including copayments, deductibles, and coinsurance.
• Track and Manage Outstanding Payments: Follow up on unpaid or misallocated payments to ensure accurate posting.
• Assist in identifying trends in payment issues and work to resolve recurring problems or delays.
• Maintain Accurate Records: Maintain organized records of all posted payments, adjustments, and any communications related to payment discrepancies
• Ensure that all payment records are accurate and up to date for reporting purposes and audits.
• Assist with Billing and Reconciliation: Work closely with the billing department to ensure that payments are accurately reflected in the billing system and patient accounts.
• Provide support during monthly, quarterly, and annual financial audits or internal reviews.

    Patient and Payer Communication:

• Communicate with patients or insurance providers to clarify payment issues, resolve discrepancies, or obtain further information on underpaid claims.
• Respond to inquiries related to payment posting or account balances.
• Compliance and Regulatory Adherence: Ensure that all payment posting activities are compliant with relevant laws, healthcare regulations (e.g., HIPAA), and payer-specific policies.

Follow internal processes and best practices for securing patient data and maintaining confidentiality.