Remote Medical Payment Posting Jobs in Riverside, CA

About Us

All Care To You is a Management Service Organization providing our clients with healthcare administrative support. We provide services to Independent Physician Associations, TPAs, and Fiscal Intermediary clients.  ACTY is a modern growing company which encourages diverse perspectives. We celebrate curiosity, initiative, drive and a passion for making a difference. We support a culture focused on teamwork, support, and inclusion. Our company is fully remote and offers a flexible work environment as well as schedules. ACTY offers 100% employer paid medical, vision, dental, and life coverage for our employees.  We also offer paid holiday, sick time, and vacation time as well as a 410k plan.  Additional employee paid coverage options available.

Job purpose

The Payment Posting Coordinator is responsible for accurately posting all non-electronic payments from health plans and health savings accounts. This role includes reviewing and correcting postings completed by automated processes, as well as handling electronic payments that could not be posted automatically. The coordinator will verify the accuracy of posted payments prior to issuing funds to providers and reconcile all payments received and posted daily.

The ideal candidate will demonstrate strong attention to detail, organizational skills, and proficiency in written and verbal communication, as regular interaction with clients and insurance representatives is required.

Duties and responsibilities

• Payment Management:
  • Review daily queries to monitor payments posted by the automated process to ensure accuracy of details posted. Correct posting as needed.
  • Review payment exception report daily to manually post payments not processed by the automated process.
  • Manually post non-electronic payments to claims in EZCap.
  • Post recoupments and corrections per company procedures.
  • Review automated posting for accuracy prior to issuing payment to providers.
  • Track and locate missing payments identified by Billing Coordinators.
  • Monitor partial payments/split claims for receipt of full payment or missing claim lines and resolve outstanding payment.
  • Reconcile payment documents received to list of manual and HSA payments reported. Use existing tracking logs and queries to ensure all reported manual payments are posted accurately and timely.
  • All other duties as assigned.
• Communication:
  • Communicate effectively with insurance companies, healthcare providers, and their billing staff to resolve claims issues and answer inquiries.
  • Document all interactions and updates in the claims management system.
• Documentation and Reporting:
  • Maintain accurate records of claim status, actions taken, and resolutions utilizing established policies and procedures.
  • Prepare and submit reports on payment activities and status updates to management as requested.
• Compliance:
  • Ensure all claims follow-up activities comply with company policies, industry regulations, and legal requirements.
  • Stay updated on changes in insurance policies, regulations, and industry standards.
  • Must meet quantitative production standard of working 100 – 150 claims per week with less than 5% error rate.
  • Attend departmental and company meetings as required.
• Problem Resolution:
  • Identify and report trends which could have an overall negative impact on claim payments such as processing errors, denials, or billing issues.
  • Investigate and resolve discrepancies or issues related to claims processing and payment.
  • Work with other team members and departments ensure proper claim submission.
• Continuous Improvement:
  • Identify and recommend process improvements to enhance the efficiency and effectiveness of the claims follow-up process.
  • Participate in training and development opportunities to stay current with best practices and industry trends.

Qualifications                                

• A minimum of 4 years’ experience as a medical payment poster or similar role.
• Solid understanding of health plan payment procedures and electronic (835) remittance files
• Knowledge of healthcare benefits, coordination of benefits, referral and authorization requirements, and insurance follow up.
• Experience with CPT Codes, ICD-10 Codes, Modifiers, and CCI edits.
• EZ-Cap experience preferred.
• Proficiency using Outlook, Microsoft Teams, Zoom, Microsoft Office (including Word and Excel) and Adobe.
• Detail oriented and highly organized.
• Strong ability to multi-task, project management, and work in a fast-paced environment.
• Strong ability in problem-solving.
• Ability to self-manage, strong time management skills.
• Ability to work in an extremely confidential environment.
• Strong written and verbal communication skills.v