Cash Posting Specialist (25-372) chez Artesia General Hospital

Description

Job Summary:  

Responsible for entering, balancing and reconciling all patient and insurance payments and recoupments for Artesia General Hospital and physician practices.

ESSENTIAL FUNCTIONS:

• Is able to prioritize daily work and assesses backlog situations, making adjustments as needed.
• Reconciles cash/contractual balances/variances, assuring accuracy of the daily bank balancing procedures.
• Identifies researches and ensures timely processing of payments, allowances, denials/rejections are recorded on individual accounts.
• Posts and reconciles electronic received insurance payments (RAP’s) accurately and timely.
• Posts and balances payments received through the mail from patients and insurance companies.
• Balance all receipts according to the Hashing Policy and Procedures.
• Print Edit, Hashing and review screens prior to posting.
• Posts ALL receipts ensuring the edit totals the check(s) amount.
• Review and work SIT categories assigned to the Receipting Department.
• Close Daily Receipts.
• Resolve and reconcile the unapplied account monthly.
• Ensures compliance with all regulatory, company, departmental and HR policies and procedures.
• Maintains strict confidentiality in accordance with HIPAA regulations and AGH privacy policies. Including divulging any patient health information (PHI) only on a need-to-know basis to payers requiring information for claims payment processing.
• Performs other duties as assigned.
• Maintains thorough knowledge of third-party payment applications, requirements and regulatory guidelines at the federal, state and local level.
• Meets all monthly and year end fiscal closing deadlines as they relate to the cash application process.
• Meets or exceeds departmental productivity standards on a consistent basis.
• Assist with the implementation of potential new systems and process changes as needed.
• Assist with training new employees as needed.
• Ensure that adjustment request have the proper supporting documentation and appropriate sign off for processing.
• Will ensure that all batches' payments and adjustment balance.
• Will make adjustments to accounts for NSF payments, included the fee to be assessed by Artesia General Hospital.
• Report any noted trends while posting manual or electronic payments.
• Post zero payments on a daily basis and forward information to the Appeals/Denials Coordinator as appropriate.
• Daily Check Out procedure with Supervisor.
• Completes all assignments on a daily basis.

ADDITIONAL RESPONSIBILITIES:

• Prompt response to e-mail and telephone calls.
• Exceptional interpersonal skills.
• Excellent communication.
• Excellent organizational skills.
• Manual Payment Posting: Input data from insurance remittance advices and patient payment batches into Patient Accounting System.
• Assist Business Office Lead/Supervisor/Manager/Director as required or assigned.
• Performs other necessary duties as required to meet the goal of providing exceptional customer service to the community and health system.
• Demonstrate awareness of age specific, cultural and spiritual practices of patients, staff and visitors.
• Understands the functional status and physical needs of patients, staff and visitors.
• Will treat all customers, coworkers, medical staff and the communities we serve with integrity and service excellence at all times as measured by documented communications to the Department Director.
• Will abide by the policies of Artesia General Hospital related to compliance.
• Will report to work on time as scheduled per the HR policy. Will be available for a full-time schedule. Will have flexibility to work evenings and weekends as necessary to meet deadlines.
• Will attend weekly and monthly meetings as required.
• Will complete annual education and training requirements.

KNOWLEDGE/SKILL/ABILITIES:

• High school diploma or equivalent required.
• 1- 3 years of experience in the healthcare setting (Hospital and/or medical office) working with insurance claims processing involving CPT, HCPCS, ICD-9CM, ICD-10CM and CMS regulations.
• Familiarity with CMS1500 and UB04 claim form completion.
• Strong analytical, oral, written communication skills.
• Familiarity with health insurance and other third-party billing practices and guidelines.
• Proficient in Microsoft Word, Excel, Access, Outlook, and the like.
• Bilingual in Spanish and English a plus.
• Must be able to assess situations, identify issues/problems and prioritize duties.
• Reasoning Ability: Uses personal experience, knowledge and other outside resources to make logical decisions to solve      problems.
• Utilizes Time Management and Organization skills.
• Attention to detail, is accurate and completes principal accountabilities timely.
• Professionalism.
• Understanding of Medical Terminology.
• 10 Key experience.

AGE-RELATED COMPETENCIES: Demonstrates the basic knowledge and skills necessary to identify age-specific patient needs appropriate for this position.

Information Management: Treats all information and data within the scope of the position with appropriate attention to confidentiality, privacy, HIPAA and security policies/regulations.

Risk Management/Quality Management/Safety: Cooperates fully in all Risk Management, Quality Management, and Safety Activities and Investigations.

MINIMUM POSITION QUALIFICATIONS: 

Ø Education – High school diploma or equivalent.

Ø Work Experience – 

o Minimum 2 years of experience in the healthcare setting (Hospital and/or medical office) working with insurance claims processing involving CPT, HCPCS, ICD-9CM, ICD-10CM and CMS regulations.

o Familiarity with CMS1500 and UB04 claim form completion.

o Strong analytical, oral, written communication skills.

o Familiarity with health insurance and other third-party billing practices and guidelines.

o Proficient in Microsoft Word, Excel, Outlook, and the like.

Ø License/Certification – none.

ENVIRONMENTAL CONDITIONS: Work environment consists of daily patient contact in a fast-paced office setting.