Payment Posting Specialist, Patient Financial Services

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We strongly encourage all candidates of diverse backgrounds and lived experiences to apply.

A Brief Overview
The Payment Specialist is responsible for deciphering the numerous types of Explanation of Benefits (EOBs) received within the Billing Department and accurately and efficiently posting those payments and denials to the billing system. During this review and posting process the Payment Specialist must be cognizant of the expected level of reimbursement based on the various Managed Care agreements. The Payment Specialist must have thorough knowledge of departmental procedures regarding the process for transferring balances to secondary insurance or self-pay or adjusting balances based on contractual agreements. Attention to detail, and accuracy are required

What you will do

• Understands and interprets third-party insurance company explanation of benefits (EOB) documents in order to determine insurance payment amount, patient balance amount, applicable contractual adjustments, and denial/non-payment reasons.
• Identifies trends regarding major reasons for incorrect payments, contractual amounts, and denials makes recommendations to management to improve turnaround, accuracy, revenue, and quality of the payment posting routine.
• Identifies the correct patient account/invoice within the billing system and posts all payments and denials as advertised on the EOB.
• Ensures that all balances are adjudicated to the appropriate responsible party during routine payment/denial posting.
• Identifies payments that are not matched to a corresponding invoice, or associated to the Malvern Services Organization and posts payment to the appropriate clearing account for further review and resolution. Completes all required paper work associated with this clearing account posting to the attention of the team lead.
• Posts all CAP payments to the correct clearing account, and accurately selects the appropriate practice location for debit adjustment posting.
• Balances payment batches against system generated payment totals prior to closing the batch, and research and resolves any discrepancy.
• Forwards completed batches to designated area for reconciliation and filing.
• Maintains department objective of 95% or greater for quality.
• Adheres to the departments policies and procedures to ensure all payments/rejections posted are handled accurately and in accordance with Compliance standards.
• Reviews quality reports provided by the Team Lead and correct all errors.
• Attends monthly quality review meetings.
• Maintains the department's objectives for production.
• Works assigned payment/denial batches
• Provides feedback regarding and posting anomalies to Supervisor/Team Lead.
• Other duties as assigned.

Education Qualifications

• High School Diploma / GED Required
• Associate's Degree Preferred

Experience Qualifications

• At least three (3) years in a physician billing environment Preferred

Skills and Abilities

• Ability to work in a high volume production environment.
• Excellent communication skills.
• Knowledge of Physician Billing (Epic experience preferred).
• Strong interpersonal skills and excellent phone etiquette.
• Ability to work independently, meet specific goals and objectives; proven ability to prioritize.
• Ability to handle confidential materials.
• Excellent organizational skills and strong attention to detail.
• Flexibility to work overtime as needed/required.
• Strong math aptitude.
• Experience with personal computers and data entry

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must be fully vaccinated against COVID-19 and receive an annual influenza vaccine. Learn more.

Employees may request exemptions for valid religious and medical reasons. Start dates may be delayed until candidates are immunized or exemption requests are reviewed.

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