Job Description

Primary Functions:

1. Payment Processing & Posting

• Post payments from insurance companies, government programs (Medicare/Medicaid), and patients into the RCM system.
• Process Electronic Remittance Advices (ERA) and manual Explanation of Benefits (EOB).
• Apply necessary adjustments, refunds, and write-offs per payer guidelines. • Balance and reconcile daily deposits with posted payments.

1. Denial Management & Reconciliation

• Identify and post insurance denials while ensuring timely follow-up for resolution. • Work with the billing and accounts receivable teams to correct claim errors and resubmit claims.
• Track underpayments and escalate discrepancies to the RCM Manager.

1. Reporting & Documentation

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

1. Communication & Collaboration

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

Job Qualifications:

1. Bachelor’s degree in accounting, Finance, Business Administration, or a related field (preferred).
2. 1-3 years of experience in medical billing, payment posting, or revenue cycle management.
3. Experience working with RCM software (e.g., EPIC, eClinicalWorks, NextGen, Athenahealth,Kareo or Cerner
4. Strong understanding of insurance reimbursement, medical billing, and denial management.
5. Proficiency in MS Excel, accounting principles, and payment reconciliation.
6. Knowledge of HIPAA regulations and compliance standards.