Reimbursement Specialist- Cash Applications

1 day ago

Boothwyn PA United States Pentech Healthcare Full time
The responsibility of this role is to ensure that all cash/denial/adjustment transactions are performed timely, accurately and in adherence to Pentec Health's compliance program. The RS Cash Application is accountable for performing all analytical and financial support functions within the department in accordance with internal Policy and Procedure.

Looking for someone near the PA/DE area and able to come onsite to our Boothwyn office when needed.

Essential Job Duties:

Cash Posting
  • On a daily basis, the Cash Applications will accurately post cash receipts, denials and adjustments from 3rd party remittances and Explanations of Benefits (EOB) to the appropriate patient invoices as indicated on the remittance/EOB documents. Organize and prepare lockbox deposits for cash posting and distribution to appropriate team on a daily basis. Cash is to be posted.
  • Determine if credit balances are duplicate or overpayments that must be adjusted and/or transferred to a liability account and subsequently refunded to the payer or patient. Contact insurance payers for missing remittances when necessary
  • Utilize all available reports to reconciles cash receipts posted to cash reported on deposit by the banking institution on a daily basis and/or per batch, as outlined and established by policy. At the end of the month, generate and review reporting to ensure transactions are properly posted. Corrects any errors or misstatements as needed.
  • Use discretion and experience to identify and communicate any discrepancies to the attention of the Supervisor. All adjustments approved and received within a given month are to be posted to CPR+ before the close of each calendar month.
  • Post insurance carrier take-back/recoupment. Tracks and reports subsequent utilization of take-back/recoupment based upon review of reimbursements EOB and compares against any known outstanding liabilities per finance records.
  • Accurately and concisely document accounts so that information can be readily understood by others throughout the company.
Projects
  • Involvement in a variety of projects and audits as outlined by leadership. The scope of such project may include but not limited to: pricing analysis; payer audits; assessment of credit balances for refund or revenue adjustment; payment analysis of HCPCS coding for non-contracted payers; cash trends; and DSO reporting.
*Other job duties and special projects as assigned.

Ideal Candidate Will Have:
  • Associates degree, some college coursework and/or a combination of education and experience.
  • Minimum of 2 years hands-on experience in a billing, collections or cash posting role within a physician office, specialty infusion, home care or related field required.
  • Proficiency in CPR+ or similar platform; Experience with MS Office, especially Word, Excel, and PowerPoint, with a focus on creating and developing spreadsheets, presentations, and reports effectively and efficiently.
  • Demonstrated ability to review remittance from a variety of payers, investigate issues with invoices and confer with internal and external parties to resolve discrepancies
  • Ability to calculate figures and amounts correctly, such as interest and percentages, and reconciling cash posted to cash received. Basic understanding of 3rd part Reimbursement processes.
  • Clear and effective communication of the American English language via face-to-face, telephone, and written communication. Troubleshooting: ability to anticipate issues, research and implement creative solutions.
  • Ability to work independently and as part of a team environment. Proven self-starter ability to work with little to no direct supervision.
  • Dependable and adherence to deadlines. Strong organizational and problem-solving skills including being solutions oriented and ability to communicate a sense of authority through subject matter expertise and resourcefulness.
Salary Range: $45,000 annually

Pentec Health offers a comprehensive compensation and full benefits package. Actual pay will be based on several factors such as qualifications and skills for the role plus geographic location.

Benefits may include but are not limited to medical, dental, vision, 401k match, PTO, paid holidays, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits

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