[Hiring] Payment Application Specialist @WVU Medicine

Role Description

Responsible for posting insurance and/or patient payments to Epic and balancing those postings to the bank deposits in a timely and accurate manner. Posting can include electronic processing of remittance posting files or manually posting payments from a paper remittance. Assists Departmental Coordinator in researching and resolving outstanding deposits and unidentified or missing payments.

Qualifications

• High School Graduate or equivalent.

Requirements

• One (1) year medical billing/medical office experience preferred.
• Bookkeeping and cash balancing experience.

Core Duties and Responsibilities

• Processes electronic remittances initiating transaction posting in Epic.
• Works transactions that do not post correctly to ensure that transactions route to the appropriate accounts.
• Identifies any unidentified payment transactions that route to the clearing account, following facility processes to move non-patient money to correct general ledger account.
• Balances postings to bank deposits utilizing provided technical tools in Epic and via Microsoft Excel.
• Maintains timely and accurate posting according to departmental goals and report to management.
• Documents accounts clearly and accurately.
• Analyzes and reconciles posting amounts from patient payment and other sources of payment (non-accounts receivable (AR) cash) to the patient accounting system and accounting department.
• Uses system software, including online credit card systems and the Epic system.
• Creates, enters, and assigns cash management batches.
• Opens and distributes mail received from the post office and financial institutions for the various entities services are billed for.
• Contacts the appropriate third party payors, business entities, or financial institutions to resolve unidentified or missing payments.
• Accesses any scanned information via One Content imaging system.
• Completes and reconciles bank deposits daily.
• Utilizes remittance work queues to resolve payment errors.
• Reviews and reconciles all postings monthly with the Departmental Coordinator as needed.
• Participates in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth.
• Researches accounts in work queues with credit or undistributed self-pay balances, and works to resolve these balances by distributing to other outstanding account, refunding another approved facility, or refunding the guarantor.
• Investigates insurance overpayments and takes appropriate action from within the work queue to resolve the variance.
• Processes refund requests received from third party payors, clinical departments, other areas of Revenue Cycle, and leadership.
• Monitors accounts that fall within our special billing guidelines (i.e. cosmetic, bariatric, IVF, plastics, etc.) to ensure pre-payment application is done within a timely manner.
• Works with the appropriate accountants to maintain a list of all unclaimed property, and maintain a spreadsheet for submission to the state.
• Takes calls from registration and customer service staff experiencing issues with cash drawers, and works to resolve the issues.
• Insures all refund requests are received from accounts payable, and processes the checks for submission to third party or guarantor.
• Maintains current knowledge of payor payment provisions and all local, state, and federal collection laws.
• Contacts insurance company or employer to determine eligibility, benefits, and payment information necessary to refund or distribute payments.
• Ability to accurately utilize payor portals to initiate overpayment recoveries.
• Identifies missing charges and communicates with appropriate coding manager for re-entry.
• Completes reports assigned by Revenue Cycle leadership for bulk refunds to third party payors.
• Monitors work queue for inappropriate hospital payments posted to professional billing, and works with appropriate entity for posting.
• Assists hospital cashier’s office in locating and resolving missing receipts.
• Aids accounting department in reconciling patient payments for the entity in which the receipt was deposited.

Physical Requirements

• Must be able to sit for extended periods of time.
• Must have reading and comprehension ability.
• Visual acuity must be within normal range.
• Must have manual dexterity to operate keyboards, fax machines, telephones and other business equipment.

Working Environment

• Office type environment.

Skills and Abilities

• Excellent oral and written communication skills.
• Knowledge of medical terminology preferred.
• Knowledge of third party payers preferred.
• Knowledge of business math preferred.
• Knowledge of ICD-10 and CPT coding processes preferred.
• Excellent customer service and telephone etiquette.
• Ability to use tact and diplomacy in dealing with others.
• Knowledge of patient accounting principles and procedures.
• Working knowledge of computers.
• Maintains knowledge of current online banking systems.

Additional Job Description

• Scheduled Weekly Hours: 40
• Shift: Exempt/Non-Exempt: United States of America (Non-Exempt)
• Company: SYSTEM West Virginia University Health System
• Cost Center: 663 SYSTEM Cash Management