Cali, Colombia
Role and Responsibilities
The RCM Specialist is responsible for accurately and timely posting of all insurance and patient payments. Payers either send an EOB (explanation of benefits) or ERA (electronic remittance advice) towards the payment of a claim. The cash/payment posting staff posts these payments immediately into the respective patient accounts, against that claim to reconcile them.
DUTIES AND RESPONSIBILITIES:
- Interpret, evaluate, and clarify research requests to determine potential payment issues.
- Post payments received in different forms into the practice management system, including but not limited to:
(a) Lockbox remits
(b) Electronic remits
(c) Undistributed accounts
(d) Manual remit posting
(e) Zero cash posting
(f) Correspondence remit manual posting
(g) Unposted/missing payments
(h) EOB downloads from payer websites
- Analyze EOB information, including co-pays, deductible, co-insurance, contractual adjustments, denials and more to very accuracy of patient balances.
- Review the payment information to ensure that there is no missing or incomplete information.
- Properly posting denials in practice management system and communicating the same with accounts receivable team for timely follow-up.
NECESSARY ATTRIBUTES:
- Strong organizational skills.
- Excellent attention to detail with a focus on accuracy, and quality
- Proficient with Microsoft Office Suite or related software.
- Proficient in the English verbally and in written communications.
- Ability to multi-task, establish work priorities, work with interruptions, prioritize needs to meet required timelines and deal effectively with confidential information.
- Maintain confidentiality of all patient demographic, medical, and financial information, ensuring proper handling and disposal of confidential documents and adherence to HIPAA.
- Proficient in examining documents for accuracy and completenes
QUALIFICATIONS:
- High School diploma required.
- Ability to interpret Explanation of Benefits (EOB) – preferred.
Demonstrated ability to work with numbers quickly and accurately with an understanding of basic accounting techniques.