Remittance Processor / Payment Poster - Remote/Hybrid Opportunity

Rochester, NY

Responsibilities

Position Summary:

With latitude for initiative and judgment the Payment Poster is responsible for the accurate and timely posting of third party payments, insurance denials and patient responsibilities to individual patient accounts, research of unidentified payments and balancing of holding/clearing and offset accounts. Requires the ability to prioritize work and manage time effectively to meet daily and monthly posting and deposit deadlines. The position calls for independent thinking, good communication, organization and math skills and the ability to pay attention to detail. The Payment Poster will represent the department and hospital in a professional manner, protecting confidentiality of patient information at all times.

Supervision and Direction Exercised:

Responsible for monitoring own performance on assigned tasks against procedure standards. May train and coordinate activities of peers as directed by Operations Supervisor and Manager.

Machines and Equipment Used:

Standard office equipment, including but not limited to desktop computer, Epic billing system, , OnBase Document Scanning System, Microsoft Office Excel, RightFax, telephone, photocopy machine, 10 key adding machine

Typical Duties:

30% Manual Insurance Payment Posting

  • Responsible for the proper and timely cash application and balancing of a substantial variety of commercial, workers compensation, no fault, miscellaneous insurance (State Aid, Federal, New York State, other hospital, 1199) payments received via live checks, EFTs, or through the lockbox

  • Review remittances to identify and calculate the correct allowed amount, payment amount, patient co-pay, co-insurance, deductible and interest total

  • Balance and post payments, patient responsibility and denial codes to the correct hospital account, payer and liability bucket in Epic billing system

  • Evaluate offsets for accuracy, post offsets and record information to properly account for forward balances and completed offsets

  • Utilize clearing accounts for special scenario payments

  • Scan, sweep and index documents in OnBase

  • Access payer websites via the internet to obtain pertinent information for processing remittances

  • Organize and maintain payment information in files to meet retention standards according to University and auditing policies

15% Manual Insurance Denial Posting

  • Post zero payments, patient responsibility and denial codes to correct payer and bucket in Epic billing system

  • Analyze and code explanation of benefits with the correct rejection total and denial code

  • Access payer websites via the internet to obtain pertinent information for posting denials

  • Organize and maintain payment information in files to meet retention standards according to University and auditing policies

15% Research and Communication

  • Act as a liaison between Patient Financial Services and Medicare/Medicaid/Blue Cross/MVP and Commercial Insurance agencies concerning duplicate, insufficient, missing or erroneous payments

  • Problem solve unidentified payments received that do not have adequate documentation for posting

  • Research in Epic billing system for patient HARs, visits, invoices and open balances

  • Contact hospital departments and insurance companies to inquire where payment should be applied

  • Communicate with Patient Financial Services staff regarding duplicate or erroneous payments, rejections, adjustments or indexing issues

  • Respond to inquiries from insurance companies regarding payment related questions such as overpayments

10% Lockbox and Mail

  • Prepare lockbox payment batches – print daily lockbox reports, batch summary and cover sheets, sweep batches into OnBase

  • Account for all lockbox batches included in the days lockbox and notify Supervisor of any problems

  • Identify and flag checks received in lockbox that have corresponding electronic 835 file for automated posting

  • Print, sort and distribute correspondence only items

10% Balance and Post Electronic 835 Files

  • Responsible for the proper and timely cash application of electronic 835 payments received via live checks or EFTs

  • Validate EFTs and checks have been received before posting

  • Balance payments received to file totals and report any missing EFTs/checks or out of balance situations

  • Ensure that the electronic 835 files do not contain duplicate payments

  • Update Excel logs with 835 file information

  • Inform Analysts when remittance files are balanced and ready to process and when problems with the file occur

  • Evaluate offsets for accuracy and record information to properly account for forward balances and completed offsets

  • Access payer websites via the internet to obtain pertinent information for processing remittances

  • Organize and maintain payment information in files to meet retention standards according to University and auditing policies

10% Balance Holding/Clearing Accounts and Transfer Payments

  • Responsible for reconciling and balancing individual holding/clearing and offset accounts

  • Maintain appropriate back-up for auditing purposes

  • Appropriately transfer insurance and patient monies between proper accounts and insurance levels

  • Transfer payments to/from appropriate University/Hospital ledger accounts

5% Training

  • Continuously cross-train to enable assistance and fill in as appropriate

5% Other Duties as Assigned

  • Scan and index correspondence and remittance documents into OnBase for Epic batches

  • Access the intranet to get information from the PFS SharePoint and other University sites

Expectations

  • Participate in department/team staff meetings, educational classes and training

  • Stay current on HIPAA guidelines through education and reading monthly emails.

  • Participate in educational training such as ICare and Annual Mandatory In Service

  • Join PFS committees such as planning PFS events or addressing employee issues

  • Write up procedures to document work processes

Qualifications

Associates degree in Accounting and 2 years related cashiering or banking experience; or an equivalent combination of education and experience.

NOTE: This document describes typical duties and responsibilities and is not intended to limit management from assigning other work as required.

The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.

How To Apply

All applicants must apply online.

EOE Minorities/Females/Protected Veterans/Disabled

Location: Strong Memorial Hospital
Full/Part Time: Full-Time
Opening: Full Time 40 hours Grade 007