Medical Payment Entry Specialist at Providence Community Health in Warwick, Rhode Island

Job Description:

Providence Community Health

Medical Payment Entry Specialist
Employee - Full Time
Indiv Contrib-Union
Warwick, Warwick, RI, US

The Medical Payment Entry Specialist will perform tasks and functions associated with all aspects of entering third party reimbursements/self pay payments. The Medical Payment Entry Specialist will follow the established job performance standards for the position and must have the fundamental knowledge of an FQHC or physician billing procedures.

Essential Duties & Responsibilities:

• Imports/uploads electronic 835 files daily.

• Upload all 835 from Emdeon each daily
• Uploads all non Emdeon 835 files
• Convert non-Emdeon 835 files to readable format

• Uploads & saves PDF remittances from internal and external sources for electronic copy.

• Find PDF information via Emdeon or the external payer site
• Upload to saved folder on the Billing Drive
• Create new folders for each month as needed

• Maintain Excel spreadsheet of monies received by payer and by date in order to reconcile at day and month end.

• Document application of deposit information received from finance through electronic funds transfers
• Verify matching 835 file
• Document any discrepancies on the Excel spreadsheet from 835 file
• Reconcile end of days deposits to spreadsheet

• Maintains accurate and timely posting of payments remitted to PCHC through 835 process and checks received in the mail from insurance companies and patients.

• Reviews payment information
• Verify correct information such as payer, check date, check number & amount
• Applies the 835
• Prints out exception report
• Reviews exceptions for reason
• Manually enters payment or denial information

• Insurance receipts of remits are processed accurately.

• Print daily journal
• Verify payment information using patient name, ID number, date of service
• Verify all denials have been entered

Education and/or Experience

• Two to three years experience in payment posting and third party medical billing or healthcare finance.
• High School diploma, with preference given with a billing certificate or an Associates Degree.

PCHC is EOE/M/F/D/V/SO

Equal employment opportunity, including veterans and individuals with disabilities.

PI266847465

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