Reconciliation Specialist

Position Summary: Responsible for assisting Patient Accounts leadership in ensuring that daily and monthly department processes are completed to ensure expedient collection of payments at the maximum level of reimbursement allowed for the services provided by Orthopedic ONE physicians.


Responsibilities/Accountabilities:

Financial Reconciliation:

1. Oversees established billing processes related to the practice management system:
   1. Balances daily income with the end of day reports out of the practice management system.
   2. Review practice management system daily report to confirm correct location, facility, and

company fields were chosen for claims with Payment Specialist.

1. Makes daily deposit
   1. Live checks using the electronic deposit machine (EDM).
   2. Cash deposits from satellite sites cash outs and ensures deposited at the bank by end of day.
2. Pulls daily reports from online payment processor for distribution to Payment Specialists:
   1. Manage errors and/or refunds for credit cards.
3. Verify receipt of end of day totals report (co pay log sheets) from off site locations and is saved in an electronic folder and disperse to Payment Specialists.
4. Refunds
   1. Refunds patient and insurance unapplied payments that cannot be reconciled to account
   2. Prepares refund checks weekly to be mailed with refund check and letter from practice regarding the refund patient and insurance is receiving.
   3. Ensures accounts are noted appropriately with refund information in the EMR A/R notes.
5. Enters the daily totals on Orthopedic One balancing spreadsheet:
   1. Verifies on the Orthopedic One spreadsheet that the totals match the practice management system totals.
   2. Run daily total from EMR to update accounting spreadsheet.
   3. Keep cash log for satellite locations to reconcile cash and check deposits
   4. Takes appropriate steps to resolve any discrepancies.
6. Verifies that the credit card settlement statements match what was posted in the practice management system.
7. Completes assigned To Do's daily. Ensuring response to To Do is according to status assigned (1 Normal - Respond within 3 days, 2 Priority - Respond within 2 days, 3 Urgent - Respond within 1 day).
8. Provides daily posting number by Payment Specialist to Supervisor weekly.

Month End Process:

1. Verifies all deposits have been posted into the practice management system and carries over those not posted to the new monthly spreadsheet.
2. Post collection check and reports payment to collection agency.
3. Runs unapplied reports for patients and insurance to reconcile accounts.
4. Ensures bank adjustments and insufficient funds notifications are reconciled monthly.

Projects:

1. Reviews reports from Finance for previous EMR payments by location, provider and referring provider.
2. Reports error trends to Supervisor for review.
3. Conducts special projects and studies as requested by Director.

Customer Service and Communications:

1. Communicates with patients, insurance carriers and other outside entities in a professional manner. Identifies solutions and responds professionally to patient concerns, i.e., pleasant tone of voice, courteous language, etc. Uses appropriate grammar and demonstrates tact and diplomacy in patient interactions, by phone and in person.
2. Diffuses negative situations with patients and maintains a pleasant and professional tone during stressful circumstances and heavy workload.
3. Communicates with staff members in a professional, pleasant manner; Shares information relevant to work, no gossiping or disparaging remarks, accepts work without complaint or provides reasons why assignment is unmanageable, asks and answers questions related to improving department performance.

Teamwork:

1. Works cooperatively with coworkers, providers, and management.
2. Shares knowledge and insights with co-workers in a constructive manner.
3. Willingly provides coverage to department, staying beyond scheduled ending time when clinic schedule demands it, volunteering to cover time off or unexpected absences, maintaining workflow in department without direct supervision.
4. Addresses conflicts with person directly before involving manager or uninvolved peers.
5. Is considerate of others with regard to taking breaks or meal periods, use of computer and telephone, and noise in department.

Policies and Procedures:

1. Knows and complies with policies and procedures as enumerated in the Orthopedic One Employee Handbook and policies and procedures documents.
2. Provides assistance and support to leadership in implementing policies and procedures as necessary.
3. Actively participates in training, and conducting day to day work activity by adhering to all policies and procedures as enumerated in compliance and risk management programs.

Education, Experience, and Certification/Licensure Required:

The applicant must have a minimum of five years experience working in a business office setting, preferably in healthcare. Experience in the payment posting process and EMR system of Orthopedic One strongly preferred.
Knowledge, Skills, and Abilities:

Must be experienced in Microsoft Office products including Word and Excel. Must be able to create/setup new spreadsheets using formulas, pivot tables, etc; Knowledge of basic accounting principles used in balancing of spreadsheets; Able to plan, organize and prioritize assignments and follow through on assignments and job duties to completion without direct supervision; Able to project a professional, tactful and diplomatic image to patients and employees; Effective interpersonal and communication skills; Able to maintain patient confidentiality and observe HIPAA guidelines.