Job Description
Primary Functions
1. Payment Processing & Posting
· Post payments from insurance companies, government programs (Medicare/Medicaid), and
patients into the RCM system.
· Process Electronic Remittance Advices (ERA) and Manual Explanation of Benefits (EOB).
· Apply necessary adjustments, refunds, and write-offs per payer guidelines.
· Balance and reconcile daily deposits with posted payments.
2. Denial Management & Reconciliation
· Identify and post insurance denials while ensuring timely follow-up for resolution.
· Work with the billing and accounts receivable teams to correct claim errors and resubmit
claims.
· Track underpayments and escalate discrepancies to the RCM Manager.
3. Reporting & Documentation
· Maintain accurate payment records and reconciliation reports.
· Generate daily, weekly, and monthly reports on payment trends, denials, and discrepancies.
· Ensure compliance with company policies and industry regulations (HIPAA, Medicare
guidelines).
4. Communication & Collaboration
· Coordinate with the billing team, accounts receivable, and insurance companies to resolve
Payment discrepancies.
· Respond to inquiries from internal teams regarding posted payments.
· Escalate unresolved payment issues to the appropriate leadership.