Job Description

Primary Functions:
Payment Processing & PostingAccurately post payments received from insurance companies, government programs (such as Medicare/Medicaid), and patients into the Revenue Cycle Management (RCM) system. Efficiently process Electronic Remittance Advices (ERAs) and manual Explanation of Benefits (EOBs). Apply necessary adjustments, refunds, and write-offs in accordance with payer guidelines. Balance and reconcile daily deposits with posted payments to ensure accuracy.

Denial Management & ReconciliationIdentify and accurately post insurance denials, ensuring timely follow-up for resolution. Collaborate with the billing and accounts receivable teams to correct claim errors and facilitate claim resubmissions. Track underpayments and escalate discrepancies to the RCM Manager for further action.

Reporting & DocumentationMaintain precise payment records and reconciliation reports. Generate daily, weekly, and monthly reports on payment trends, denials, and discrepancies. Ensure strict compliance with company policies and industry regulations, including HIPAA and Medicare guidelines

Communication & CollaborationCoordinate effectively with the billing team, accounts receivable, and insurance companies to resolve payment discrepancies. Respond promptly to inquiries from internal teams regarding posted payments. Escalate unresolved payment issues to the appropriate leadership as needed.

Additional :Any bachelor's degree. Good Communication Skills (Written and Verbal). 1-3 years of proven experience in payment posting within a healthcare environment is essential Strong understanding of healthcare revenue cycle management (RCM) processes. Proficiency in interpreting Electronic Remittance Advices (ERAs) and Explanation of Benefits (EOBs) with healthcare-specific knowledge. Experience with healthcare-specific RCM software (e.g., Epic, Cerner, NextGen, Athenahealth, Kareo, or similar).

Soft/Behavioral Skills:Problem-Solver: Identifies and resolves healthcare billing discrepancies. Organized: Manages high volumes of medical remittances efficiently. Clear Communicator: Effectively discusses payment issues with healthcare teams. Analytical: Understands healthcare financial data and denial patterns.

Shift Timing: Day Shift (8am to 5pm IST)/ Work Mode: Work from Office-Mumbai