Payment Associate-4

Primary Functions

• 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.
• 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.
• 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).
• 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.
  
  

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