Description
Healthcare Cash Specialist
Description:
- Performs all activities related to the posting of non-dues revenue received at the Regional office and all medical facilities to the subsidiary Accounts Receivable system.
-
Balances and reconciles all funds processed to ensure (SOX) Sarbanes-Oxley compliance.
-
Processes 835 electronic remittances; researches and resolves errors to ensure accurate posting of insurance and guarantor payments.
-
Performs manual data entry of non-dues revenue into the patient accounting system, including line item payment posting.
-
Posts third party payments, contractual adjustments, deductibles, co-pays, take backs and denials, in accordance with the explanation of benefits received.
-
Balances and reconciles cash totals of each manual batch, 835 remittances or other electronic file uploaded into the system using available resources and reconciliation tools: splitter Router reports, bank portal for lock box image and/or treasury tools, in order to reconcile monthly with General Accounting Department totals.
-
Researches guarantor and insurance credit balances by reviewing insurance plan explanation of benefits, determining insurance plan primacy using coordination of benefit rules, reviewing member's medical chart and eligible benefits.
-
Resolves member and insurance credits balances within required SOX guidelines by debit adjusting, refunding or distributing credit balance payments to outstanding balances.
-
Performs root cause analysis and works with appropriate resources to reduce errors and volume of insurance and guarantor credits.
-
Maintains records of unidentified payments, actions taken and resolution; researches and processes unidentified checks/funds.
-
Maintains audit files and daily reconciliation spreadsheet related to cash posting for SOX control purposes
-
Researches, deposits and records monies payable to our Health Plan of the Mid-Atlantic States, MAPMG, our Hospitals and Claims Recovery into dedicated database using correct GL string.
-
Prepares journal entries using the One Link system and submits entries to the General Accounting Department.
-
Submits reclassification journal entries as needed to balance the General Ledger.
-
Performs other related duties as directed.
Requirements:
-
High School Diploma or Equivalent REQUIRED, Associate's degree preferred
-
Four years of electronic and manual cash posting experience working with health insurance, workers compensation and/or third party payers.
-
Two years of experience in standard cash handling and reconciliation procedures
-
Proficient in Microsoft Office Suite and Excel required.
-
Understanding of medical billing practices required, including knowledge of ICD-9, CPT and HCPCS codes.
-
Familiarity using and creating Business Objects reporting preferred.
-
Experience working in large company within the health care industry using multiple and complex systems.
-
Prior accounting background a plus.