Payment Researcher

$55,723 - $79,144/Yr

University of California - Los Angeles, CA

Full-time

Los Angeles, CA

Educational Services

About the position

The Payment Researcher at UCLA Health plays a crucial role in supporting the payment posting processes within the accounts receivable system. This position is essential for ensuring accurate financial reporting and operational excellence in healthcare. The researcher will manage payment postings, interpret payer explanations, and handle patient credit balances, contributing to the overall efficiency of revenue operations.

Responsibilities

• Manage all aspects of payment postings within the accounts receivable (A/R) system.
• Interpret payer Explanation of Benefits (EOBs), including patient responsibilities, contractual adjustments, interest amounts, and denial/remark codes.
• Identify and apply payments and retractions from various payers, using appropriate payment codes, source codes, and remark codes in the A/R system.
• Handle patient credit balances by processing refunds or transferring payments between hospital and professional accounts.
• Conduct payment research and cashiering functions as needed to support accurate financial reporting.

Requirements

• High school diploma or GED.
• Minimum of 3 years of relevant experience, including at least 1 year in collections investigation.
• Experience in commercial and managed care collections, highly desired.
• Ability to interpret payer contracts and process contractual adjustments.
• In-depth knowledge of UB04 requirements and medical billing processes.
• Strong analytical skills and proven proficiency in Excel and spreadsheets.
• Understanding of collection techniques and laws, including AB1455, the Knox-Keene Act, Health & Safety Codes, etc.
• Familiarity with medical terminology, CPT codes, HCPCS codes, health networks, IPAs, HMOs, PPOs, PCPs, and contract affiliations.
• Excellent verbal and written communication skills.
• Proficiency in Microsoft Office, especially Excel and Word.
• Exceptional organizational skills, with the ability to meet deadlines, work independently or as part of a team, and prioritize tasks effectively.