Payment Associate-1

Primary Functions:

Payment Processing & Posting


* Accurately post payments received from insurance companies, government programs (such as Medicare/Medicaid), and patients into the Revenue Cycle Management (RCM) system.


* Efficiently process Electronic Remittance Advices (ERAs) and manual Explanation of Benefits (EOBs).


* Apply necessary adjustments, refunds, and write-offs in accordance with payer guidelines.


* Balance and reconcile daily deposits with posted payments to ensure accuracy.

Denial Management & Reconciliation


* Identify and accurately post insurance denials, ensuring timely follow-up for resolution.


* Collaborate with the billing and accounts receivable teams to correct claim errors and facilitate claim resubmissions.


* Track underpayments and escalate discrepancies to the RCM Manager for further action.

Reporting & Documentation


* Maintain precise payment records and reconciliation reports.


* Generate daily, weekly, and monthly reports on payment trends, denials, and discrepancies.


* Ensure strict compliance with company policies and industry regulations, including HIPAA and Medicare guidelines

Communication & Collaboration


* Coordinate effectively with the billing team, accounts receivable, and insurance companies to resolve payment discrepancies.


* Respond promptly to inquiries from internal teams regarding posted payments.


* Escalate unresolved payment issues to the appropriate leadership as needed.

Additional Job Description:


* Any bachelor’s degree.


* Good Communication Skills (Written and Verbal).


* 1-3 years of proven experience in payment posting within a healthcare environment is essential


*  Strong understanding of healthcare revenue cycle management (RCM) processes.


* Proficiency in interpreting Electronic Remittance Advices (ERAs) and Explanation of Benefits (EOBs) with healthcare-specific knowledge.


*  Experience with healthcare-specific RCM software (e.g., Epic, Cerner, NextGen, Athenahealth, Kareo, or similar).

Soft/Behavioral Skills:


* Problem-Solver: Identifies and resolves healthcare billing discrepancies.


* Organized: Manages high volumes of medical remittances efficiently.


* Clear Communicator: Effectively discusses payment issues with healthcare teams.


* Analytical: Understands healthcare financial data and denial patterns.

Shift Timing: Day Shift (8am to 5pm IST)/ Work Mode: Work from Office-Mumbai