Payment Posting Specialist

The Payment Posting Executive is responsible for accurately posting insurance and patient payments into the medical billing system while ensuring compliance with payer guidelines and organizational policies. The role involves reviewing Electronic Remittance Advice (ERA), Explanation of Benefits (EOB), identifying payment discrepancies, processing adjustments, reconciling transactions, and collaborating with the Accounts Receivable (AR) team to resolve payment-related issues.

The ideal candidate should possess strong analytical skills, attention to detail, and a good understanding of the US medical billing payment posting process.

Key Roles & Responsibilities

Payment Posting

• Accurately post insurance and patient payments into the billing system.
• Process Electronic Remittance Advice (ERA) and Explanation of Benefits (EOB).
• Ensure all payments are posted within the defined turnaround time.
• Verify payment amounts before posting.
• Post payments received through electronic transfers, checks, virtual cards, and other payment methods.

Payment Reconciliation

• Reconcile posted payments with bank deposits and payment reports.
• Ensure payment totals match daily deposit records.
• Identify and investigate posting mismatches.
• Maintain complete financial accuracy while posting transactions.

Adjustments & Write-offs

• Process contractual adjustments as per payer contracts.
• Apply approved write-offs and payment corrections.
• Post patient responsibility amounts including deductibles, copayments, and coinsurance.
• Ensure adjustments comply with company policies.

Denial & Variance Identification

• Identify underpayments, overpayments, zero payments, and denied claims.
• Flag payment discrepancies for further investigation.
• Escalate unresolved payment issues to the Accounts Receivable (AR) team.
• Document reasons for payment variances.

Revenue Cycle Support

• Coordinate with Billing, Coding, and AR teams for payment-related clarifications.
• Assist in resolving unidentified payments.
• Support correction of posting errors when identified.
• Ensure proper claim status updates after payment posting.

Reporting & Documentation

• Maintain daily productivity reports.
• Submit quality reports as required.
• Track pending payments requiring follow-up.
• Maintain complete documentation for audits.

Compliance

• Follow HIPAA regulations and maintain strict confidentiality of patient information.
• Adhere to company policies and standard operating procedures.
• Ensure compliance with payer guidelines.
• Participate in internal quality audits whenever required.