Insurance Pymnt Posting 2 MGBO

Insurance Payment Poster 2

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Job Summary

The Insurance Payment Poster 2 will support director and manager with reports and special projects. Provide support, training, and research for team members (i.e. PC functions, Excel, Word, imaging).

Core Responsibilities and Essential Functions

Primary Responsibilities:

• Contact identified payor sources to resolve problems or issues with payment application and balancing.
• Transmit required documentation to third-party payors for the purpose of resolving payments
• Ensure all payor contact is fully documented in the appropriate software application
• Recommend accounts for contractual or administrative write-off, along with appropriate justification and documentation
• Consistently meet the current productivity standards in posting insurance payments (as assigned)
• Consistently meet the current quality standards in posting payments from insurance companies by posting received payments within the performance metrics outlined by the department. (as assigned)
• Meet productivity standards, targets, error ratios, and reporting requirements as assigned by the department manager or supervisor
• Provide individual contribution to the overall team effort of achieving the department goals, initiatives
• Identify opportunities for system and process improvement and submit to management
• Demonstrate proficient use of systems and execution of processes in all areas of responsibilities
• Demonstrate knowledge of HIPAA privacy standards and ensure compliance with system PHI privacy practices
• Follow the WellStar general policies and procedures, the Departments policies and procedures, and the Emergency Preparedness Procedures
• Follow JCAHO and outside regulatory agencies mandated rules and procedures
• Utilize assigned menus and pathways and work queues from within the current and legacy software applications to escalate problems to the appropriate supervisor
• Utilize assigned menus and pathways in foreign software applications and report software application to escalate problems to the appropriate supervisor
• Utilize assigned computer hardware and report hardware problems to the appropriate supervisor or service desk.
• Participate in the testing for assigned software applications, including verification of field integrity
• Perform other duties and responsibilities as assigned.

Daily Responsibilities:

• Posting of payments, adjustments, patient coinsurance, copays, & deductibles including all Reason codes as well as remarks codes as reported by the payor.
• Responsible for resolving payments posted into unapplied cash accounts within 15 days.
• Posting of zero EOBs and use appropriate denial and remarks codes.
• Posting of credit card payments received via mail/agencies/rejected WebPay transactions.
• Posting of payment transfers.
• Posting of vendor/agency payments.
• Posting of all bonus and incentive payments as assigned.
• Maintain balancing and work log and crosstraining with other payment posting functions.
• Daily Functions: Payment corrections, Payment Posting Reports and DPL paperwork are to be completed daily (as assigned). The Productivity Report should be updated daily so that the Team Lead can verify the previous weeks activity regularly.
• Transactions Goal: Insurance deposits (EFT/Lockbox), agency deposits, and/or Zero EOBs unposted less than or equal to 1 business day.
• Un-Distributed cash monthly average of less than or equal to of 1.0 day of average cash collections
• Report to work on time and as scheduled.

Professional Development:

• Attend staff meetings, in-services, and continuing education.
• Assist in the development of indicators, thresholds, study methods, and data collection as assigned.
• Respond to problems/opportunities to improve care/customer service.
• Support involvement in system performance improvement initiatives.
• Assist with special projects as assigned.
• Work closely with other staff, co-workers, peers, and other members of the healthcare team to ensure a positive and effective work environment.
• Complete all required training by assigned due dates.

Professional Communication:

• Maintain confidentiality in matters relating to patient/family.
• Assure patient privacy and confidentiality as appropriate or required.
• Initiate communication with peers about changes and procedures.
• Relay information appropriately over telephone, email, and other communication devices.
• Interact with internal customers including A/R Follow-up, Payment Variance, Charge Capture Claim Edits as well all all patient facing operational sites and our SBO customer support team.
• Conduct yourself and communication in a professional manner at all times.
• Performs other duties as assigned
• Complies with all WellStar Health System policies, standards of work, and code of conduct.

Required Minimum Education

High school diploma

Required Minimum License(s) and Certification(s)

All certifications are required upon hire unless otherwise stated.

Additional License(s) and Certification(s)

N/A

Required Minimum Experience

Minimum 4 years work experience in healthcare automated cash applications. Required

Required Minimum Skills

Basic knowledge of medical terminology Basic experience and knowledge of PC applications Detailed-oriented, good organizational skills, and ability to be self-directed Strong time management skills, managing multiple priorities and a heavy workload in a high-stress atmosphere Flexibility to perform other tasks as needed in an active work environment with changing work needs High-level problem solving, analytical, and investigational skills Excellent internal/external customer service skills Excellent communication skills to include oral and written comprehension and expression Ability to: learn quickly and meet continuous timeline, productivity, and QA standards exhibit behaviors consistent with principles of excellent service demonstrate and maintain competency as required for job title and the unit/area(s) of assignment exhibit behaviors consistent with standards of performance improvement and organizational values (e.g., efficiency and financial responsibility, safety, partnership & service, teamwork, compassion, integrity, and trust & respect)

Join us and discover the support to do more meaningful workand enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.