Accounts Receivable Technician II

Kent Campus Hospital

STATUS: Full Time 80 Hours

SHIFT: Days

GENERAL SUMMARY:

Summary:
This position is accountable for processing all daily cash receipts to patient accounts for the Medical Center, Bayhealth Medical Group and Medical Alternative Care, calculating and completely analyzing remittance advises to ensure payment and required contractual allowances are applied accurately. Identifies and maps payer specific denial codes to ANSI standard denial codes for denial posting to ensure appropriate actions are taken on claims. Responsible for reviewing undistributed and other payment error queues to maintain unapplied cash and reconciling items at a minimum. Reviews unreconciled control groups in Cash Management to apply payments to claims. Reviews patient pay credit balance queues monthly to apply credits. Performs necessary actions to reconcile refund checks issues and complete the refund transaction. This position restricts PTO on the last two business days of the month to enable a timely month end close. Responsible for delivering a positive patient experience, in every dimension, every time, related to how the proper handling of cash receipts impacts patients and families.

ESSENTIAL FUNCTIONS & ACCOUNTABILITIES:

1. Post assigned cash control groups imported into Epic daily. Post lockbox payments from remittance images available in PNC Pinnacle software. Mark legacy account receivable payment amounts as external AR and complete posting in respective legacy system. Accurate posting of payments to patient accounts with the proper contractual allowances on all remittances and patient mail received. Searches for and identifies closed or voided invoices to post payments against. Interprets remittance advice from insurance companies. Post zero payment denials and patient responsibility amounts accurately using Claim Adjustment Reason Codes provided by the payers and choosing the appropriate default code for payers using proprietary codes. Accurately identifies and posts provider level adjustments and payer retractions. Ensure all payments and correspondence is processed within 48 hours of receipt of a matched payment and remittance.
2. Balance and approve all cash control groups and other batches with no open or unbalanced batches by end of shift. Through batch level detail, balancing reports and remittance images in PNC, identifies and resolves all payment/adjustment errors, and credit balances created during posting process. Researches and corrects errors in cash control groups when they are created with inaccurate control totals.
3. Conduct phone calls to insurance and patients regarding payments to determine the correct patient account where the payment should be applied. Accesses payer websites to retrieve Explanation of Benefits for manual posting. Calls Bayhealth provider entities to identify and resolve any legacy AR system payments and provides a copy of the payment detail to the entity. Escalates payment issues unresolved after 3 days to management.
4. Resolves all payments placed in unapplied within 7 days. Escalates to management those payments they are not able to resolve/address timely.
5. Reviews loaded and assigned electronic remittance advice file runs. Accepts runs in a processed status. Work Remittance work queue, research runs remaining in a loaded status for more than 3-5 days. As needed, reviews electronic remittance advice raw data files to trouble shoot electronic posting and balancing errors and/or to split the file.
6. Corrects reported posting errors within 2 business days.
7. Maintain posting productivity standards and post all remittances received via mail or courier as well as credit card payments. Maintain patient confidentiality and all HIPAA regulations in necessary communication.
8. All other duties as assigned within the scope and range of job responsibilities

REQUIRED MINIMUM EDUCATION AND CREDENTIAL:

• 
  
  
  
• Credential

EXPERIENCE:

Required: Three years banking, bookkeeping or hospital and physician payment processing experience Preferred: Five years hospital and physician payment processing experience.

PREFERRED EDUCATION AND CREDENTIAL:

• Education
• Credential

To view a full list of all open position at Bayhealth, please visit:

https://apply.bayhealth.org/join/