Planned Parenthood of Orange and San Bernardino Counties has a full-time hybrid ( 2 days working remote 3 days in office ) opportunity for a Medical Payment Poster in Anaheim, CA.
The Payment and Reconciliation Analyst at PPOSBC and Melody Women’s Health is responsible for reviewing, interpreting, and analyzing explanations of benefits (EOB) from insurance carriers to post appropriate payments, non-payments, adjustments, deductibles, copays, non-covered and denial transactions to open patient claims and refunding credits.
At PPOSBC, we understand the importance of a well-rounded benefits program and are dedicated to providing you with unique benefits that meet the needs of you and your family. We are proud to offer a range of plans that help protect you in the case of illness or injury including:
A competitive benefits package including medical, dental, and vision coverage for you and eligible dependents, life insurance, and long term disability.
Benefits coverage starts after one full month of employment!
Generous vacation, sick, and holiday benefits!
Generous 401(k) matching contributions and more!
To view our detailed benefits guide, please visit our career site at www.pposbccareers.org
Responsibilities
Essential Functions: Essential functions encompass the required tasks, duties and responsibilities performed as part of the job and the reason the job exists.
Post all manual checks, ACH payments, and adjustments daily.
Post all non-EDI payments, zero-pay EOBs, contractual allowances, denial codes, deductibles, and copayments.
Post insurance payments, insurance supplement payments, and Prop 56 payments on the payment log.
Must ensure Capitation and Prop 56 RA (remittance advice) are attached to all payments.
All payments must be posted within one day of receipt
Post all EC-OTC payments.
Performs appropriate follow-up with payer for payment when in receipt of ERA
Pull EOBs from payer websites and other applications as needed.
All credit card payments must run daily and posted to the transaction in eCW.
Research unidentified payments to determine appropriate resolution.
Update and maintain all logs and spreadsheets used for reconciliation.
Identify credit balances at the time of posting and submit a refund request for approval.
Patient refund requests must be logged on A/P patient reimbursement log and Vendor import log when submitting 10 or more patients within one week.
Enter refunds in eCW in a timely manner.
Identify payment trends and notify Manager.
Non-Essential Functions:
Other duties as assigned.
PHYSICAL REQUIREMENTS:
The physical requirements of this position are identified below. Reasonable accommodations may be made for individuals with disabilities to perform the essential functions of this position.
CORE COMPETENCIES – WE CARE:
Welcoming: Anticipates customer requirements and gives high priority to customer satisfaction and service. Handles problems quickly and efficiently. Maintains a pleasant, positive and professional approach. Embraces opportunities to help team members, stakeholders, and other departments.
Equitable: Creating equitable access and opportunity for all through education, practicing inclusive behavior, elevating others’ voices, creating spaces for honest conversation, and listening without judgment. Values and uplifts our collective diversity within in our agency.
Confidential: Respects the information shared by our patients, employees, and vendors and maintains appropriate confidentiality. Follows all policies and laws that protect private & privileged information.
Accessible: Is available and approachable to others, open-minded, fair and non-defensive. Appreciates constructive feedback and is a team player. Demonstrates good listening skills.
Respectful: Values diversity and treats everyone with dignity and courtesy. Dependable and courteous of other people’s time and commitments.
Empathetic: Demonstrates interest and understanding in other people’s feelings, attitudes and reasoning. Maintains an open and non-judgmental demeanor that is patient, flexible, and understanding.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Minimum Education:
High School Diploma.
Associate’s or Bachelor’s Degree preferred or equivalent experience in related field.
Minimum Work Experience:
Minimum of 3 year’s recent experience in cash balance, cash posting or cash applications.
Intermediate Excel skills, including working with tables, filters, and multiple spreadsheets.
Medical and Insurance terminology essential.
Other Requirements:
Strong data entry skills; ability to input a high volume of information.
Must thrive in a fast-paced, rigorous environment with changing priorities.
Ability to meet deadlines and work under pressure.
Must demonstrate high-level computer skills, including; Microsoft Word, Excel, and Outlook.
Agency Standard Requirements:
Strong commitment to quality healthcare and excellent customer service is required.
Must thrive in a fast-paced, rigorous environment with changing priorities.
Ability to meet deadlines and work under pressure.
Must demonstrate high-level computer skills, including; Microsoft Word, Excel, and Outlook. Electronic medical records experience may also be required.
Abortion patients are cared for at each of our health centers and in part through the administrative, support, and other non-clinical services provided at all PPOSBC locations and by all PPOSBC employees, and supporting these critical services is an essential job duty and fundamental responsibility of all employees.
