Payment Posting Reconciliation Specialist

Join Our Team as a Payment Posting and Reconciliation Specialist!

ABOUT ONE HEALTH OHIO

One Health Ohio is a Federally Qualified Health Center (FQHC) providing an integrated healthcare delivery model to patients in our communities. We provide quality, compassionate services in medical, dental, behavioral health, recovery and pharmacy to our patients.

Essential Duties / Essential Job Functions:

• Post electronic and manual insurance payments, patient payments, contractual adjustments, denials, credits, refunds, and recoupments accurately and within established turnaround times.
• Review electronic remittance advice, explanations of benefits, lockbox files, bank documentation, and other payment source materials.
• Balance payment batches to remittance totals, deposits, and system-generated reports before final posting.
• Reconcile posted batches and promptly research and correct variances, duplicate postings, misapplied payments, and other discrepancies.
• Research and resolve unapplied cash, unidentified payments, credit balances, and rejected or failed remittance files.
• Review daily cash and deposit reports to confirm that all assigned payments have been posted and accounted for.
• Identify and report recurring denial, underpayment, recoupment, and payer-processing trends to leadership.
• Maintain complete and accurate documentation supporting payment-posting activity and account adjustments.
• Communicate professionally with payers, patients, internal departments, and other stakeholders when information is needed to correctly apply or reconcile payments.
• Generate and review routine productivity, balancing, exception, and reconciliation reports.
• Protect patient health and financial information in accordance with HIPAA, organizational policies, and applicable requirements.
• Assist with audits, month-end activities, workflow improvements, cross-training, and other assigned revenue-cycle functions.
• Adhere to all ONE Health Ohio policies, procedures, compliance requirements, and core values.
• Communicate professionally, respectfully, and constructively with patients, coworkers, leadership, and external contacts.
• Support a collaborative work environment and address workplace concerns through appropriate supervisory or Human Resources channels.
• Maintain reliable attendance and arrive prepared to perform assigned duties.
• Meet department-established productivity, accuracy, quality, documentation, and timeliness standards.
• Communicate operational, compliance, reconciliation, and workflow concerns promptly to the supervisor.
• Demonstrate adaptability when assignments, priorities, systems, or workflows change.
• Complete assigned work based on department needs and established service-level expectations.

Required Skills/Abilities:

• High school diploma or equivalent
• At least two years of medical billing, payment posting, cash application, accounts receivable, or related healthcare revenue-cycle experience.
• Ability to interpret electronic remittance advice and explanation of benefits
• Knowledge of insurance payments, contractual adjustments, denials, recoupments, credits, refunds, and patient responsibility.
• Experience reconciling payment batches, remittance totals, and deposits.
• Proficiency with practice-management systems, spreadsheets, and standard office applications.
• Strong attention to detail, numerical accuracy, organization, analytical thinking, and problem-solving skills.
• Ability to maintain the continentality and security of patient and financial information.

Preferred Qualifications:

• Associated degree or recognized medical billing, coding, or revenue-cycle certification.
• Experience with NextGen or the organization's applicable practice-management platform
• Experience in an FQHC or multispecialty healthcare environment.
• Familiarity with Medicare, Medicaid, Medicaid managed-care, and commercial payer remittances.
• Experience with ERA/835 processing, lockbox payments, credit balances, and unapplied cash.

Benefits:

• PTO and Paid Holidays
• Optional Medical, dental and vision plans
• 401(k) retirement plan
• Company-paid life insurance with/AD&D benefit
• Company-paid long-term disability plan
• Optional life insurance and short-term disability plan
• Optional Critical Illness Plan
• Optional Accident Insurance Plan

NOTE:  This job description is not intended to be all-inclusive. Employee may perform other related duties as negotiated to meet the ongoing needs of the organization. Employee is able to work at any OHO locations deemed necessary by OHO.