Payment Processing Analyst

Overview

Purpose: The Payment Processing Analyst is responsible for troubleshooting issues that occur on the estimation system. This Analyst ensures that EDI payments are accurate prior to posting to the patient’s account and is responsible for auditing all payments for accuracy.

Responsibilities

Essential Functions

 

  • Identifies researches, corrects and documents discrepancies in estimation system.
  • Collaborates with credentialing payor relations and EV Support team to prevent future estimation errors.
  • Reviews and corrects insurance attachment discrepancies on patient accounts.
  • Analyzes trends and corrects errors as needed.
  • Processes EDI payments and corrects transactions for accurate electronic payment posting.
  • Monitors and reviews the correspondence submitted by other RCO departments for EDI and manual payment posting errors.
  • Develops new EDI payment opportunities with payors.
  • Audits manual payment posting by business associates.
  • Runs various reports for analysis and trends.
  • Continuous improvement requirements up to 4 hours a week.
  • Other duties and projects as assigned.

Qualifications

Required Skills and Experience

 

Education/Experience

  • Associate’s or Technical degree required. Bachelor’s degree strongly preferred.
  • 1-3 years revenue cycle experience required, dental (or healthcare) preferred.
  • 1-3 years electronic data interchange experience dental (or healthcare) preferred.

 

Knowledge/Skills/Abilities:

This position requires that candidates embody the principles of our core values and demonstrate aptitude in the following areas:

  • Analytical ability; Ability to analyze contracts, interpret metrics and understand workflows.
  • Coaching; Ability to impart information to another in a constructive and support manner with the goal of accomplishing change.
  • Detail oriented focus; Ability to work with complex claims.
  • Flexibility; Ability to adapt to change and willingness to take on new tasks.
  • Interpersonal and relationship building skills; Ability to establish and maintain positive working relationships, internally and externally.
  • Open to Change; Willing to help change a policy, program, cultural tradition that is outdated, or no longer beneficial to the group as a whole.
  • Process improvement-minded; Ability to enhance and develop performance by analyzing current data and processes along with openness to feedback and constructive criticism.
  • Professional communication skills; Ability to tactfully present information in clear and understandable manner.
  • Professional integrity; Ability to work independently with a high level of professionalism, dedication and commitment.
  • Proficient with technology; Ability to utilize Microsoft Office applications, databases, EHR and practice management software, as well as, internet applications.
  • Results‐oriented; Ability to meet deadlines and hold vendors accountable to service level agreement.
  • Revenue Cycle Focused ; Ability to understand how revenue flows into and out of an organization
  • Time management; Ability to prioritize and efficiently process claims.
  • Resourceful; Utilizes the resources available to you. If you don't know the answer to something find out by asking questions or seeking information.

 

Work Environment

  • Office with cubicle environment, head sets may be utilized, but not required.
  • Fast-paced office environment.

 


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