Job Purpose
This position will be located in the Plano Office and will provide support services for all 15 locations. The position will report directly to the Chief Financial Officer. The Reconciliation Specialist is responsible for performing manual and electronic posting functions for all Managed Care and Commercial plans, reconciliation of bank deposits, and process medical records requests. Follows standard procedures and pre-established guidelines to complete tasks.
****Texas Retina Associates is Texas’ largest, most experienced ophthalmology practice focused specifically on the diagnosis, medical and surgical management of diseases of the retina and vitreous. Our fellowshipped and specialty trained physicians care for the most complicated retina conditions such as ocular cancer and uveitis. This physician owned medical group provides services at 15 locations throughout the DFW metroplex, Waco, Wichita Falls and Lubbock.
Essential Duties
Responsible for the timely and accurate posting of payments.
Assists customer service representatives with payment issues and researches missing payments and / or misapplications for both operating regions.
Maintain credit balances of patients and payors ensuring timely refunds within government guidelines/regulations.
Posts adjustments to customers’ accounts as needed.
Accurately apply payments, process refunds or re-submit accounts as needed
Efficiently process incoming paperwork utilizing department resources as needed
Provides notification of daily activity to accounting for reconciliation purposes
Must be able to meet strict posting deadlines to ensure that Manager can complete monthly reporting requirements
Identify patterns and trends that indicate a potential issue
Review reports, researches and resolves issues.
Review payment postings for accuracy and ensure account balances are current.
Participate in the implementation of procedures to improve the quality of work being processed.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below represent the knowledge, skill and /or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
Minimum Education and Experience
2 years of Outpatient Clinic Payment Posting
Experience with NextGen (EMR) is preferred
Knowledge of payer contracts and (EOBs), explanation of benefits
Experience working in a clearinghouse
Understanding of HIPAA regulations
Strong verbal and written skills
Must have great attention to detail and avoid data entry errors
Excellent communication skills
Must have strong organizational skills and effective time management
A positive, open and friendly attitude to colleagues and clients
Superior customer service and professionalism
Skills and Specifications
Work under minimum supervision and demonstrate strong initiative. Make independent decisions when circumstances warrant; make prompt and accurate judgments.
Excellent communication with physicians, patients and staff is required.
Must be articulate in English speech, writing and understanding.
Strong ability to listen, answer all questions as simply as possible and take action when needed to resolve issues.
Excellent organization skills; solid attention to detail to ensure accuracy of information
Proven analytical skills; recognize, evaluate, solve problems, and correct errors, and develop processes that eliminate redundancy
Use independent judgement to escalate issues to manager, as necessary.
Must be willing to work under pressure.
Excellent Microsoft Office Suite skills including Excel, Word, Outlook and Access
Attend work as scheduled and/or required.
Complete all other duties as assigned.
Physical Requirements
Sedentary with prolonged sitting, talking and working at computer.
Hear and use hands and fingers to operate and handle keyboards and controls
Occasionally required to walk, bend and reach with hands and arms
Must be able to lift up to occasionally lift, carry and/or move up to 25 pounds. Specific vision abilities include close vision and the ability to adjust focus.