Job Details

Payment Posting Specialist

United WestLabs (UWL) is seeking a detail-oriented Payment Posting Specialist to accurately post and reconcile patient, insurance, and government payments while maintaining compliance with applicable billing and reimbursement guidelines. This position plays a critical role in ensuring the accuracy of accounts receivable records, identifying payment discrepancies, and supporting the organization's revenue cycle operations.

Essential Duties and Responsibilities

Payment Processing:

• Accurately post patient, insurance, government, and collection agency payments to the appropriate patient account and date of service.
• Apply payments and adjustments according to payer requirements, reimbursement guidelines, and established departmental procedures.
• Verify payment accuracy and ensure proper allocation of contractual adjustments, denials, patient responsibility amounts, and non-covered charges.
• Reconcile payment batches and research discrepancies to ensure balanced and accurate posting.

Insurance and Government Payment Posting:

• Review and interpret Explanation of Benefits (EOBs), Remittance Advices (RAs), and other payer documentation.
• Post commercial insurance, Medicare, Medicaid/Medi-Cal, and other government payer reimbursements accurately.
• Identify payment variances, denials, non-covered services, underpayments, overpayments, and patient responsibility amounts.
• Route supporting documentation and denial information to the appropriate revenue cycle personnel for follow-up and resolution.

Reconciliation and Reporting:

• Balance payment batches by comparing system-generated reports and payment documentation.
• Investigate and resolve payment posting discrepancies in a timely manner.
• Maintain documentation related to collection agency payments and reporting requirements.
• Identify and document credit balances and overpayments according to established procedures.

Compliance and Quality:

• Maintain confidentiality of patient, financial, and organizational information in accordance with HIPAA and company policies.
• Ensure compliance with all applicable payer regulations, billing requirements, and internal controls.
• Contribute to the accuracy and integrity of accounts receivable records.
• Participate in process improvement initiatives and cross-training activities as assigned.

Required Qualifications

• High School Diploma or equivalent required.
• Minimum six (6) months of medical billing, payment posting, healthcare revenue cycle, or related experience.
• Working knowledge of medical billing, accounts receivable processes, and healthcare reimbursement practices.
• Experience reviewing and understanding EOBs, RAs, denials, adjustments, and patient responsibility determinations.
• Basic proficiency with Microsoft Office applications, including Outlook, Word, and Excel.
• Ability to accurately perform data entry with strong attention to detail.
• Strong analytical, problem-solving, organizational, and time management skills.
• Effective verbal and written communication skills.
• Ability to work independently and collaboratively in a team environment.
• Demonstrated professionalism, integrity, and commitment to ethical business practices.

Preferred Qualifications

• One (1) year or more of medical billing or payment posting experience.
• Experience with multiple payer types, including commercial insurance, Medicare, Medicaid, and collection agencies.
• Familiarity with healthcare practice management or billing software systems.

Core Competencies

• Attention to Detail
• Accuracy and Quality Focus
• Accountability
• Problem Solving
• Time Management
• Teamwork and Collaboration
• Customer Service Mindset
• Adaptability and Flexibility

Physical Requirements

• Prolonged periods of sitting and computer work.
• Frequent keyboarding, data entry, and use of standard office equipment.
• Occasional walking, standing, bending, squatting, and reaching.
• Ability to perform repetitive hand and finger movements associated with data entry and computer use

The statements contained herein are intended to describe the general nature and level of work performed by employees assigned to this position. They are not intended to be interpreted as an exhaustive list of all duties, responsibilities, qualifications, or working conditions. Management reserves the right to modify, add, or remove duties as business needs require.