JOB SUMMARY
The Remittance Processor is responsible for handling various forms of payments, ensuring they are accurately posted and reconciled in a timely manner. Â This role resolves discrepancies and problem-solves unbalanced transactions by conducting research and making adjustments while maintaining detailed end-of-day and end-of-month financial reports. Â The Remittance Processor supports organizational compliance by adhering to established policies and procedures and collaborates with cross-functional teams to enhance the efficiency and accuracy of payment processing operations. Â Effective communication, attention to detail, and adherence to deadlines are crucial in this role to ensure timely and accurate payment posting and reconciliation.
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ESSENTIAL JOB FUNCTIONS
- Recognizes and posts line-item data including payments, discounts, coordination of benefits, patient responsibility, and denial codes in accordance with organizational policies.
- Troubleshoots and resolves discrepancies related to payment entries, including eligibility issues, carrier codes, payment types, and denial mismatches.
- Accurately analyzes and breaks down complex claims, linking line items to corresponding services provided.
- Applies discounting guidelines consistent with various insurance carrier agreements.
- Reconciles electronic remittance files, un-postable payments, and other related payment types with remittances, Explanation of Benefits (EOBs), Electronic Remittance Advice (ERA’s), and other payment documentation to maintain accurate financial records.
- Verifies all EFT deposits, scanned payments and lockbox payments have been posted timely.
- Utilizes various systems and software applications to accurately track, monitor, and reconcile payments.
- Collaborates with the billing team to resolve billing-related issues that impact payment posting, providing support and expertise as needed.
- Identifies opportunities for process improvements and efficiencies in payment posting workflows.Â
- Maintains thorough and accurate documentation of payment posting activities, including notes on payment discrepancies, adjustments, and resolution efforts.
- Follows policies, procedures, phone expectations, and customer service standards to ensure prompt assistance with customer inquiries.
- Understands the impact of processing and closing electronic payment files on all departments, patient statements, and reporting.
- Maintains strict adherence to scheduled work hours with regular and reliable attendance.
- Performs other duties as assigned.
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EDUCATION AND EXPERIENCE
- High school diploma or equivalent.Â
- Experience demonstrated in data entry, calculator and math skills.Â
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CERTIFICATIONS / LICENSES
Valid Wisconsin Driver’s License required with an acceptable motor vehicle record (MVR), per FHC guidelines.
Equal Opportunity Employer
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