Payment Workflow Specialist I

Role Description

The Payment Workflow Specialist is responsible for reviewing trip records for accuracy, including payment amounts, contractual adjustments, patient responsibility, and payer details. This role involves correcting posting errors, investigating account discrepancies, and ensuring payments are accurately processed. The specialist will conduct quality assurance checks, respond to posting-related inquiries, and assist in resolving issues efficiently.

• Review trips to verify that payments are posted correctly and match contractual agreements and patient responsibility.
• Correct posting errors and document changes for record-keeping and future reference.
• Review payments for trips sent to collections to ensure accurate handling and proper reporting to the agency.
• Conduct quality assurance checks on payment posting processes, including NSA trips and trips flagged for write-offs.
• Investigate missing payments, determine the cause, and take appropriate actions to resolve and update payment records.
• Respond to emails related to trip questions from internal and external associates.
• Investigate items flagged for non-posting due to missing EOBs, ensuring timely resolution and accurate posting.
• Respond to posting-related inquiries from clients, vendors, and internal team members in a timely manner.
• Adhere to all HIPAA privacy policies and procedures; this includes always maintaining the confidentiality and security of sensitive patient information.
• Maintain consistent compliance with company attendance policies.
• QA BPO posting functions.
• Additional job duties as assigned.

Qualifications

• High School Diploma or equivalent required.
• 1–2 years of experience in medical billing and basic accounting principles preferred but not required.
• Strong experience with payment posting, deposit reconciliation, and refund research.
• Proficiency with Practice Management Systems (PMS).
• Ability to navigate various websites efficiently for remittance retrieval.
• Skilled in 10-key data entry (minimum 10,000 keystrokes per hour).
• Ability to type at least 35 WPM.
• Proficiency in Microsoft Office, including Excel (basic functions such as adding/removing rows/columns, AutoSum, and copying worksheets).
• Strong attention to detail and accuracy in financial transactions.
• Ability to read and interpret Explanation of Benefits (EOBs).
• Excellent time management and multitasking skills.
• Strong organizational skills with the ability to meet deadlines.
• Experience balancing accounts and reconciling payments.
• Strong communication skills to interact effectively with clients, vendors, and internal teams.
• Ability to maintain confidentiality and handle sensitive financial data with discretion.
• Capability to work efficiently in a fast-paced environment.
• Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment.

Benefits

• Competitive salary, commensurate with experience.
• Comprehensive benefits package, including 401(k) Plan.