- Receive and review payment documents, including explanation of benefits (EOBs), remittance advices, and electronic payment files
- Match payments to corresponding patient accounts and verify the accuracy of payment details
- Enter payment information into the healthcare organization's billing and accounting systems
- Ensure that payments are posted accurately, including the allocation of payments to the correct services, procedures, and accounts
- Reconcile payments and adjustments to the expected amounts based on contractual agreements, fee schedules, and insurance contracts
- Identify and resolve any discrepancies, such as underpayments, overpayments, or denials
- Identify and address denied or rejected claims by investigating the reason for denial, correcting errors, and resubmitting claims as necessary
- Work closely with the billing and coding teams to ensure proper claim adjudication
- Validate payments against expected reimbursement rates, contracted fee schedules, and established billing guidelines
- Identify any discrepancies and escalate issues to the appropriate personnel for resolution
- Generate reports on payment posting activities, including payment trends, outstanding balances, and accounts receivable status
- Provide regular updates to the management team to facilitate financial analysis and decision-making
- Adhere to healthcare industry regulations, such as HIPAA, and ensure that payment posting processes comply with established policies and procedures
- Protect patient confidentiality and maintain the security of sensitive financial information.
- Prior experience in payment posting or healthcare revenue cycle management
- Good understanding of medical billing, coding, and reimbursement processes
- Knowledge of medical terminology, CPT, HCPCS, and ICD coding systems
- Familiarity with insurance payer guidelines, including Medicare and Medicaid
- Proficient in using healthcare billing systems and electronic medical records (EMR) software
- Strong attention to detail and accuracy
- Excellent analytical and problem-solving skills
- Effective communication and interpersonal skills
- Ability to work independently and collaboratively in a team environment.
- Familiarity with HIPAA regulations and compliance requirements
Senior Executive - Noida, India - Access Healthcare Services
Description
Job Description
Job Requirements
To be considered for this position, applicants need to meet the following qualification criteria:
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