Job Summary:

The intent of this job description is to provide a summary of the major duties and responsibilities performed in this job. Incumbents may be requested to perform job-related tasks other than those specifically presented in this description.

The Payment Posting and Reconciliation Specialist is responsible for ensuring the accurate and timely posting of payments across multiple Patient Financial Systems. This role involves running financial reports to reconcile banking transactions with system records and maintaining a monthly revenue tracker to support financial reconciliation and month-end closing processes. The Specialist will work closely with the Revenue Cycle team to meet established timelines and financial goals.

Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Post insurance and patient payments accurately, ensuring all batches are reconciled and matched to system totals.
• Generate and review reports to reconcile banking transactions with system data, supporting the monthly closing process.
• Identify and analyze payment and denial trends; proactively investigate discrepancies and recommend corrective actions.
• Collaborate with internal and external accounting departments to track deposit information.
• Research missing payments and follow up on unresolved issues.
• Maintain daily deposit and monthly reconciliation trackers to ensure accurate financial reporting.
• Provide support for patient and staff billing inquiries, resolving questions related to payments.
• Publish monthly reconciliation reports for senior leadership review.
• Communicate effectively with patients, providers, support staff, and administrators to ensure smooth financial operations.
• Ensure compliance with company policies, procedures, and regulatory requirements.
• Assist with other duties and special projects as assigned.

Required education and experience: The requirements listed below are representative of the knowledge, skills, and/or ability required.

Minimum Education required:

• High school diploma or equivalent required.
• College degree in healthcare administration, finance, or related field preferred.

Minimum Experience Required:

• Proficiency with Patient Financial Systems, including Epic, eClinicalWorks, Experity, and Athena.
• Minimum 5 years of experience in healthcare accounts receivable, finance, or accounting.
• At least 3 years of hands-on experience in payment posting, insurance remittance reconciliation, and accounts receivable follow-up.

Minimum Knowledge and Skills Required:

• In-depth knowledge of professional fee (pro-fee) billing, including CMS, OIG, commercial insurances, and regulatory guidelines.
• Strong understanding of payor payment adjudication processes and remittance advice, including EOBs, ERAs, and rejections.
• Proficiency in basic accounting principles such as debits, credits, and reconciliations.
• Hands-on experience posting payments from Medicare, Tricare, and other major payers.
• Ability to identify patterns and trends in payments, providing actionable feedback to improve processes.
• Self-motivated, resourceful, and able to work independently with minimal supervision.
• Proficient in Microsoft Office 365 applications (Excel, Word, Outlook), with strong Excel skills for data analysis and reporting.
• Experience using multiple Practice Management Systems (Epic, eClinicalWorks, Experity, Athena) to input and research financial data.
• Strong critical thinking and analytical skills with the ability to interpret medical documentation.
• Open to feedback and committed to continuous improvement.