Medical Claims Payment Posting, Reconciliation & Reporting Specialist
Company:Abby Care
Location:US
Languages:English
Seniority level:Middle, 3-5 years
Experience:3-5 years
Skills:
Data AnalysisMicrosoft ExcelProblem SolvingAccountingAttention to detailComplianceReportingData entryAnalytical thinking
Requirements:
High school diploma or equivalent; associate degree or business/healthcare coursework preferred. 3-5 years of experience in medical billing, payment posting, or healthcare revenue cycle operations. Strong knowledge of ERAs, EOBs, CPT/ICD-10 codes, and insurance payer processes. Proficiency with billing systems (e.g., Epic, Athena, NextGen, eClinicalWorks, Kareo, etc.). Proficiency with Excel/Google Sheets. Excellent attention to detail. Strong analytical skills. Ability to work independently with high accuracy. Strong communication skills. Strong problem-solving skills.
Responsibilities:
Accurately post insurance claim payments, adjustments, and denials. Review and interpret EOBs and ERAs. Apply contractual adjustments and identify payment issues. Process payment batches and reconcile uploads to bank deposits. Perform daily reconciliation of posted payments against bank statements. Investigate and escalate payment discrepancies. Maintain logs of deposits, remittances, and reconciliation summaries. Conduct monthly reconciliation for internal financial reporting. Identify claim denials, partial payments, or payer inconsistencies. Communicate with billing teams or payers to resolve payment issues. Track denial trends and recommend corrective actions. Produce daily, weekly, and monthly payment and reconciliation reports. Generate operational reports on payment trends, payer performance, and AR. Provide analysis supporting month-end closing and financial reviews. Assist with customized reporting requests. Ensure compliance with HIPAA, payer guidelines, and internal protocols. Maintain documentation of payments, remittances, and reconciliation records. Support audit requests with detailed documentation.
