Medical Claims Payment Posting, Reconciliation & Reporting Specialist

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.) and Excel/Google Sheets. Excellent attention to detail, analytical skills, and ability to work independently with high accuracy. Strong communication and problem-solving skills.

Accurately post insurance claim payments, adjustments, and denials. Review and interpret EOBs, ERAs, and payer correspondence. Process payment batches and reconcile payment uploads to bank deposits. Perform daily reconciliation of posted payments against bank statements. Investigate and escalate discrepancies between posted amounts and actual payments. Identify claim denials, partial payments, or payer inconsistencies. Communicate with billing team members or payers to resolve payment issues. Produce daily, weekly, and monthly payment and reconciliation reports. Generate operational reports on payment trends, payer performance, and denials. Ensure compliance with HIPAA, payer guidelines, and internal financial protocols. Maintain accurate and organized documentation of payments and reconciliation records.