Payment Posting & Reconciliation Specialist-II

Payment Posting & Reconciliation Specialist-II- Houston, TX.

Senior PsychCare has an immediate opportunity for a Payment Posting Specialist with Mental Healthcare experience to support our Billing Team in Houston.

About Us:

Senior Psych Care provides fully integrative behavioral health services to the long-term care patient at their facility. Services include individual, family, and group therapies, along with diagnostic evaluation and collaborative intervention between the therapy team and the psychiatric team.

Job Description:

The Medical Payment Poster is responsible for payment posting. An ideal candidate would be responsible for ensuring precise payment posting, maintaining

accurate patient records, verifying copays and deductibles, resolving data discrepancies, and pursuing outstanding accounts.

Qualifications:

Minimum 2 years + of recent Healthcare payment posting experience (Required)

Minimum of 1 year + experience in Monthly Payment Reconciliation (Required)

Ability to work independently and prioritize workflows (Required)

Payer portal and clearinghouse experience (Required)

High school diploma or equivalent; additional education in healthcare administration or related field is a plus.

Strong understanding of insurance payment methodologies, Explanation of Benefits (EOBs), remittance advice, and insurance claim processing.

Excellent attention to detail and accuracy in data entry and reconciliation.

Effective communication skills, both written and verbal, for interacting with insurance providers, colleagues, and patients.

Ability to work independently and as part of a team, collaborating to resolve payment-related issues.

Strong organizational skills and the ability to prioritize tasks in a fast-paced environment.

Familiarity with medical coding and billing codes (CPT, ICD-10) is a plus.

Knowledge of Medicare/Medicaid and MCOs ’ billing regulations and procedures is preferred

Recent Availity Experience

Responsibilities:

Pull remits electronically and manually for daily deposits

Accurately post remits via ERA, EFT, and paper remits

Process checks and credit card payments and post to accounts

Research unapplied payments, overpayments, and credits

Post all zero remits, negative, and forward balance remits

Reconcile daily and monthly reports to avoid variance

Transfer to secondary, tertiary payor, and/or self-pay for accuracy

Assist in maintaining the RCM department KPI’s/metrics

Manage Payment posting projects

Ensure the unapplied payments are allocated daily and monthly

Work closely with the Finance team to resolve PLB and variance ledgers

Key Responsibilities:

Review insurance payment documents, including Explanation of Benefits (EOBs), remittance advice, and payment checks, to accurately determine payment amounts and reconcile them against billed services.

Utilize our electronic health records (EHR) and billing software to post insurance payments to patient accounts accurately and promptly.

Identify discrepancies between billed amounts and received payments and take appropriate actions to rectify any discrepancies, including contacting insurance providers or third-party payers.

Collaborate with other operational teams to ensure proper coding and billing practices, helping to prevent payment denials and delays.

Maintain a thorough understanding of various insurance plans, payment methodologies, and reimbursement guidelines to ensure accurate posting and reconciliation.

Monitor and track outstanding insurance payments, investigating and resolving any discrepancies or payment delays.

Generate and distribute regular reports summarizing payment posting activities, outstanding payments, and reconciliation efforts to relevant stakeholders.

Stay up to date with changes in insurance regulations, billing codes, and payment processing procedures to ensure compliance with industry standards.

Proactively identify opportunities to improve business results and/or to alert business units of trends, anomalies or health plan rules and decisions that need attention.

Participate in team meetings and training sessions to continuously improve knowledge

What we offer:

Competitive salary, commensurate with experience

Paid Time Off as well as Company-paid Holidays

Comprehensive benefits package including Medical, Dental, and Vision benefits

Life Insurance

Short- and Long-Term Disability

401(k)

Please note that this is a full-time Monday-Friday (in-person) position. Apply today and start next week!