Senior Executive

3 weeks ago

Noida, Uttar Pradesh, India Access Healthcare Services Full time
Job Description

  • Receive and review payment documents, including explanation of benefits (EOBs), remittance advices, and electronic payment files

  • Match payments to corresponding patient accounts and verify the accuracy of payment details

  • Enter payment information into the healthcare organization's billing and accounting systems

  • Ensure that payments are posted accurately, including the allocation of payments to the correct services, procedures, and accounts

  • Reconcile payments and adjustments to the expected amounts based on contractual agreements, fee schedules, and insurance contracts

  • Identify and resolve any discrepancies, such as underpayments, overpayments, or denials

  • Identify and address denied or rejected claims by investigating the reason for denial, correcting errors, and resubmitting claims as necessary

  • Work closely with the billing and coding teams to ensure proper claim adjudication

  • Validate payments against expected reimbursement rates, contracted fee schedules, and established billing guidelines

  • Identify any discrepancies and escalate issues to the appropriate personnel for resolution

  • Generate reports on payment posting activities, including payment trends, outstanding balances, and accounts receivable status

  • Provide regular updates to the management team to facilitate financial analysis and decision-making

  • Adhere to healthcare industry regulations, such as HIPAA, and ensure that payment posting processes comply with established policies and procedures

  • Protect patient confidentiality and maintain the security of sensitive financial information.

Job Requirements

To be considered for this position, applicants need to meet the following qualification criteria:

  • Prior experience in payment posting or healthcare revenue cycle management

  • Good understanding of medical billing, coding, and reimbursement processes

  • Knowledge of medical terminology, CPT, HCPCS, and ICD coding systems

  • Familiarity with insurance payer guidelines, including Medicare and Medicaid

  • Proficient in using healthcare billing systems and electronic medical records (EMR) software

  • Strong attention to detail and accuracy

  • Excellent analytical and problem-solving skills

  • Effective communication and interpersonal skills

  • Ability to work independently and collaboratively in a team environment.

  • Familiarity with HIPAA regulations and compliance requirements

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