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Payment Researcher
$55,723 - $79,144/Yr
(Not Available) - Los Angeles, CA
posted about 2 months ago
Full-time
Los Angeles, CA
About the position
The Payment Researcher plays a crucial role in a leading healthcare organization, focusing on the management of payment postings within the accounts receivable system. This position is essential for ensuring accurate revenue operations and involves interpreting payer contracts, handling patient credit balances, and conducting payment research to support financial reporting.
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
- 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
