Primary Functions:

Payment Processing & Posting

• Accurately post payments received from insurance companies, government programs (such as Medicare/Medicaid), and patients into the Revenue Cycle Management (RCM) system.
• Efficiently process Electronic Remittance Advices (ERAs) and manual Explanation of Benefits (EOBs).
• Apply necessary adjustments, refunds, and write-offs in accordance with payer guidelines.
• Balance and reconcile daily deposits with posted payments to ensure accuracy.

Denial Management & Reconciliation

• Identify and accurately post insurance denials, ensuring timely follow-up for resolution.
• Collaborate with the billing and accounts receivable teams to correct claim errors and facilitate claim resubmissions.
• Track underpayments and escalate discrepancies to the RCM Manager for further action.

Reporting & Documentation

• Maintain precise payment records and reconciliation reports.
• Generate daily, weekly, and monthly reports on payment trends, denials, and discrepancies.
• Ensure strict compliance with company policies and industry regulations, including HIPAA and Medicare guidelines.

Communication & Collaboration

• Coordinate effectively with the billing team, accounts receivable, and insurance companies to resolve payment discrepancies.
• Respond promptly to inquiries from internal teams regarding posted payments.
• Escalate unresolved payment issues to the appropriate leadership as needed.

Additional Job Description:

• Any bachelor’s degree.
• Good Communication Skills (Written and Verbal).
• 1-3 years of proven experience in payment posting within a healthcare environment is essential
• Strong understanding of healthcare revenue cycle management (RCM) processes.
• Proficiency in interpreting Electronic Remittance Advices (ERAs) and Explanation of Benefits (EOBs) with healthcare-specific knowledge.
• Experience with healthcare-specific RCM software (e.g., Epic, Cerner, NextGen, Athenahealth, Kareo, or similar).

Soft/Behavioral Skills:

• Problem-Solver: Identifies and resolves healthcare billing discrepancies.
• Organized: Manages high volumes of medical remittances efficiently.
• Clear Communicator: Effectively discusses payment issues with healthcare teams.
• Analytical: Understands healthcare financial data and denial patterns.

Shift Timing: Day Shift (8am to 5pm IST)/ Work Mode: Work from Office-Mumbai