Payment and Reconciliation Specialist

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JOB TITLE: Payment and Reconciliation Specialist

ENTITY: Olympic Sports & Spine (OSS)

LOCATION: Tacoma Billing Office

SUPERVISION RECEIVED/ REPORTS TO: Billing Office Manager/Assistant Manager

WORK SCHEDULE: Full-Time Monday - Friday , 8:00 am - 5:00 pm. ( No Weekends )

BENEFITS:

SUMMARY OF DUTIES:

At Olympic Sports & Spine (OSS), the Payment and Reconciliation Specialist is responsible for investigating credit balances, determining appropriate action, and providing resolution. Process all refund requests for patients and insurance. Some posting of insurance payments, both manually and electronically, will be required.

JOB RESPONSIBILITIES:

Position Summary: Investigate self-pay and insurance credit balances and take appropriate action for resolution.

• Investigate/research missing payments and post accordingly.
• Reconcile insurance payments in the banking system.
• Post insurance payments received electronically and on paper.
• Process paid payments that have not been allocated in a timely manner and notify the manager of any trends causing payment not to be posted.
• Identify over-payments and process refunds and recoups for insurance companies.
• Mails refund checks, attaching backup documentation.
• Properly document refund reasons in the practice management system and to the appropriate billing representative in a timely manner.
• Identifies any payments not being paid at the allowed/contracted amount and communicates this to the appropriate billing representative and manager.
• Answers patient inquiries/sets up payment plans by forwarding them to the collection specialist team.
• Maintains professional knowledge regarding medical billing and coding procedures, insurance carriers, federal programs, etc.
• Properly communicates and documents payment denials in the practice management system and to the appropriate billing representative in a timely manner.
• Identify and locate missing remittance advice.
• Able to post high-volume transactions consistently and accurately.
• Performs other duties as assigned.
• Participates in educational activities and attends monthly staff meetings.
• Be proficient with MS Office (Word, Excel, Outlook) and have experience working in multiple billing software systems.

PERFORMANCE REQUIREMENTS :

• Must be well-organized, detail-oriented, analytical, and can troubleshoot.
• Knowledge of medical billing/collection practices.
• Knowledge of computer programs.
• Knowledge of business office procedures.
• Knowledge of basic medical coding and third-party operating procedures and practices.
• Ability to operate a computer and basic office equipment. Ability to operate a multi-line telephone system.
• Skill in answering a telephone in a pleasant and helpful manner.
• Ability to read, understand, and follow oral and written instructions.
• Ability to establish and maintain effective working relationships with patients, employees, and the public.

EQUAL OPPORTUNITY STATEMENT

We are an equal opportunity employer and value diversity at our company. We do not discriminate based on age, ancestry, citizenship, color, ethnicity, family or medical care leave, gender identity or expression, genetic information, marital status, medical condition, national origin, physical or invisible disability status, political affiliation, veteran status, race, religion, or sexual orientation.

Education/Experience: Minimum High School graduation or equivalent AND three years of medical billing and collections experience.

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