Remittance Processor

JOB SUMMARY

The Remittance Processor is responsible for handling various forms of payments, ensuring they are accurately posted and reconciled in a timely manner. This role resolves discrepancies and problem-solves unbalanced transactions by conducting research and making adjustments while maintaining detailed end-of-day and end-of-month financial reports. The Remittance Processor supports organizational compliance by adhering to established policies and procedures and collaborates with cross-functional teams to enhance the efficiency and accuracy of payment processing operations. Effective communication, attention to detail, and adherence to deadlines are crucial in this role to ensure timely and accurate payment posting and reconciliation.

ESSENTIAL JOB FUNCTIONS

• Recognizes and posts line-item data including payments, discounts, coordination of benefits, patient responsibility, and denial codes in accordance with organizational policies.
• Troubleshoots and resolves discrepancies related to payment entries, including eligibility issues, carrier codes, payment types, and denial mismatches.
• Accurately analyzes and breaks down complex claims, linking line items to corresponding services provided.
• Applies discounting guidelines consistent with various insurance carrier agreements.
• Reconciles electronic remittance files, un-postable payments, and other related payment types with remittances, Explanation of Benefits (EOBs), Electronic Remittance Advice (ERA’s), and other payment documentation to maintain accurate financial records.
• Verifies all EFT deposits, scanned payments and lockbox payments have been posted timely.
• Utilizes various systems and software applications to accurately track, monitor, and reconcile payments.
• Collaborates with the billing team to resolve billing-related issues that impact payment posting, providing support and expertise as needed.
• Identifies opportunities for process improvements and efficiencies in payment posting workflows.
• Maintains thorough and accurate documentation of payment posting activities, including notes on payment discrepancies, adjustments, and resolution efforts.
• Follows policies, procedures, phone expectations, and customer service standards to ensure prompt assistance with customer inquiries.
• Understands the impact of processing and closing electronic payment files on all departments, patient statements, and reporting.
• Maintains strict adherence to scheduled work hours with regular and reliable attendance.
• Performs other duties as assigned.

EDUCATION AND EXPERIENCE

• High school diploma or equivalent.
• Experience demonstrated in data entry, calculator and math skills.

CERTIFICATIONS / LICENSES

Valid Wisconsin Driver’s License required with an acceptable motor vehicle record (MVR), per FHC guidelines.

Equal Opportunity Employer