Job Description

PAYMENT POSTING SPECIALIST

DEPARTMENT: Business Services, Billing

REPORTS TO:  Billing Manager, Director of Business Services

STATUS: Full-Time, Regular

FLSA: Non-Exempt  

ORGANIZATION INFORMATION

WellSpace Health believes that everyone deserves to be seen, no matter who you are, where you come from, where you work or what place you call home. We see you and are here for you. To that end, we have committed ourselves to finding solutions for our community’s health and wellbeing to achieve regional health through high quality comprehensive care.

Our focus has always been to offer a full range of quality medical care, dental care, mental health and behavioral health services, and enabling services to underserved people.  We do this by placing ourselves within the communities we serve and employing outstanding healthcare professionals who are devoted to our mission.

We are a Federally Qualified Health Center (FQHC) and are accredited by the Joint Commission for Ambulatory Care and Behavioral Health. We are also certified by the Joint Commission as a Primary Care Medical Home and a Behavioral Health Home.

POSITION SUMMARY

The Payment Posting Specialist ensures that payments are posted and credit balances are handled timely per WellSpace Health policy; oversees the posting and refund activities through workflows and reports, ongoing skills development, hands-on problem-solving and motivational people management.  This position is a hybrid role with a combination of remote work and in office work.

REQUIRED QUALIFICATIONS

• Billing and Coding certificate preferred or relative experience of three plus years in the healthcare industry.
• High school diploma.
• Experience in posting for a vast variety of insurance carriers for both commercial and non-commercial payors.
• Extensive knowledge of insurance, benefits, medical terminology, and medical billing.
• Experience with both manual and electronic payment posting – NextGen experience a plus.
• Proficiency with Microsoft Office suite of products as well as electronic billing systems.
• Problem solving skills.
• Attention to detail.
• Ability to maintain composure in difficult situations.
• Ability to function in team environment.
• Adherence to infection control procedures, including but not limited to, standard precautions of temperature monitoring, hand washing, symptom self-monitoring, masking and social distancing.
• Assist and support the Center/Department/Program to meet standards of High Reliability.

ESSENTIAL RESPONSIBILITIES

• Prepares and posts all payments and adjustments to patient accounts from all insurance payers and all types of payments.  This includes manual posting along with electronic remittance advice downloading.
• Prepares and posts denials to the system, manual and electronic in format.
• Imports all electronic payment files into billing system from multiple sources.
• Reviews all remittance advices for accuracy to identify errors or questionable data.
• Researches and resolves unapplied and/or unidentified cash receipts.
• Reconciles payments and shortages.
• Scans and uploads supporting documentation as needed.
• Processes patient and insurance refund requests in a timely manner.
• Investigates all insurance recoupments to determine if they are correct or need to be appealed.
• Reviews all accounts with negative balances to determine if a refund is due to the patient or insurance.
• Runs electronic deposit reports and processes payments, adjustments, and rejections, providing reconciliation and/or balancing of same.
• Posts rejections by insurance companies.
• Must meet posting productivity guidelines within department standards.
• Reviews incorrect payment amounts. Takes action to accept payment or recommend for appeal.
• Identifies errors related to posting and correct with minimal assistance.
• Performs other duties as assigned.

BENEFITS

Successful candidate will receive regionally competitive salary, above average health benefits at reduced costs, company paid life insurance & long-term disability insurance, additional voluntary retirement plan with company match and no vesting schedule requirement.

• Paid bereavement and jury duty leave
• 11 paid holidays per year
• Paid time off
• Paid sick leave
• Flexible Spending Program
• Company paid malpractice insurance for all providers
• Professional development hours offered annually

PHYSICAL DEMANDS AND WORK ENVIRONMENT

The work environment is characteristic of a medical clinic environment.  The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is frequently required to sit; use hands to handle, or feel.  The employee is also required to stand; walk; and reach with hands and arms. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, and the ability to adjust focus.   The employee must also possess hearing and speech to communicate in person and over the phone.  The noise level in the work environment is usually quiet.

The employee may be in contact with individuals and families in crisis who may be ill, using substances and/or not attentive to personal health and safety for themselves or their homes. The employee may experience a number of unpleasant sensory demands associated with the client’s use of alcohol and drugs, and the lack of personal care.  The employee may also be exposed to bodily fluids (blood, urine) and hazardous chemicals.

WellSpace Health is committed to the principals of equal employment.  We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations.  It is the intent of WellSpace Health to maintain a work environment free of harassment, discrimination, or retaliation because of age, race, religious creed, color, national origin, ancestry, physical disability, medical condition, genetic information, marital status, sex (including pregnancy, childbirth, breastfeeding and/or related medical conditions), gender, gender identity, gender expression, sexual orientation, military or veteran status, or any other status protected by federal, state or local laws.  WellSpace Health is dedicated to the fulfillment of this policy in regard to all aspects of employment, including but not limited to recruiting, hiring, placement transfer, training, promotion, rates of pay, and other compensation, termination, and all other terms, conditions, and privileges of employment.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

                                                          WELLSPACE HEALTH IS AN EQUAL OPPORTUNITY EMPLOYER

Company Description

WellSpace Health has provided care and support to individuals and families throughout the Sacramento region since 1953. Our focus has always been to offer a full range of quality medical care, dental care for children and adolescents, mental health and behavioral health services to underserved populations. We do this by placing ourselves within the communities we serve and employing outstanding healthcare professionals who are devoted to our mission. WellSpace Health is a statewide leader in designing and delivering integrated care that treats the whole person, body and mind. Our people-first approach to comprehensive healthcare means that patients are embraced by a “blanket of care” delivered with competence and compassion.