Insurance Reconciliation and Payment Specialist

Olympic Sports & Spine (OSS) is looking for a full-time, experienced

Insurance Reconciliation and Payment Specialist

Olympic Sports & Spine (OSS) is known for its fun and energetic work environment and for valuing its employees. We provide a comprehensive benefits package: https://www.osstherapy.com/employee-benefits. There is no weekend work! The schedule is Monday - Friday from 8 a.m. to 5 p.m.

SUMMARY OF DUTIES: The reconciliation and payment specialist is responsible for processing and posting insurance payments, both manually or electronically, to the proper accounts, balancing payment batches against the daily deposits, researching missing payments and insurance recoveries that show paid but not posted to patient accounts, and balancing and reconciling payment batches in the bank account.

JOB RESPONSIBILITIES:

Position Summary: Responsible for the expedient and accurate posting of payments received.

• Completes payment entry in a timely and accurate manner, including:
• Posts payments to the practice management system (EFT & Insurance checks)
• Balances batches and runs transaction reports
• Records batch totals on payment receipt spreadsheet
• Identify and locate missing remittance advice
• Able to post high-volume transactions consistently and accurately
• Identify over-payments and process refunds and recoups to both insurance companies and patients
• Verifies all EFT deposits and checks have been posted by month-end
• Process paid not allocated/posted payments in a timely manner and notify the manager of any trends causing payment not to post
• Identify over-payments and process refunds and recoups to insurance companies.
• Reconcile payment files daily with the banking system
• Properly communicates and documents payment denials in the practice management system and to the appropriate billing representative in a timely manner.
• Identifies any payments not being paid at the allowed/contracted amount and communicates this to the appropriate billing representative and Manager
• Answers patient billing questions and collects payments on accounts
• Maintains professional knowledge regarding medical billing and coding procedures, insurance carriers, federal programs, etc.
• Performs other duties as needed
• Participates in educational activities and attends monthly staff meetings.
• Be highly proficient with MS Office (Word, Excel, Outlook) and have experience working in multiple billing software systems.

PERFORMANCE REQUIREMENTS

• Knowledge of medical billing/collection practices.
• Knowledge of computer programs.
• Knowledge of business office procedures.
• Knowledge of basic medical coding and third-party operating procedures and practices.
• Ability to operate a computer and basic office equipment.
• Ability to operate a multi-line telephone system.
• Skill in answering a telephone in a pleasant and helpful manner.
• Ability to read, understand, and follow oral and written instructions.
• Ability to establish and maintain effective working relationships with patients, employees, and the public.
• Must be well-organized and detail-oriented.

Education/Experience: Minimum High School graduation or equivalent AND three years of experience in an appropriately related patient accounting function OR Equivalent education/experience.

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