Medical Claims Payment Posting, Reconciliation Specialist

🔥 13 hours ago

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Abby Care

WebsiteLinkedInAll Job Openings

51 - 200 employees

⚕️ Healthcare Insurance

👥 B2C

Healthcare Insurance • B2C

Abby Care is a service that helps families get paid for providing in-home care to loved ones with disabilities or special needs. The organization trains and certifies family caregivers at no cost, manages hiring and payroll, navigates Medicaid and insurance paperwork to secure payment, and provides a purpose-built platform, clinical support, and community resources. Abby Care operates in multiple U. S. states and focuses on enabling high-quality, compensated family caregiving through partnerships with insurers and Medicaid programs.

📋 Description

• Accurately post insurance claim payments, adjustments, and denials into the practice management or billing system. • Review and interpret Explanation of Benefits (EOBs), Electronic Remittance Advices (ERAs), and correspondence from payers. • Apply correct contractual adjustments and identify underpayments, overpayments, or missing payments. • Process payment batches and reconcile payment uploads to bank deposits. • Perform daily reconciliation of posted payments against bank statements and deposits. • Investigate discrepancies between posted amounts and actual payments; escalate unresolved variances as needed. • Maintain accurate logs of deposits, remittances, and reconciliation summaries. • Conduct monthly reconciliation for internal financial reporting requirements. • Identify claim denials, partial payments, or payer inconsistencies. • Communicate with billing team members or payers to resolve payment issues. • Track recurring denial trends and recommend corrective actions to improve clean-claim rates. • Produce daily, weekly, and monthly payment and reconciliation reports. • Generate operational reports such as payment trends, payer performance, denial summaries, and accounts receivable insights. • Provide analysis supporting month-end closing and financial reviews. • Assist leadership with customized reporting requests. • Ensure compliance with HIPAA, payer guidelines, and internal financial protocols. • Maintain accurate and organized documentation of payments, remittances, and reconciliation records. • Support audit requests by supplying detailed payment and reporting documentation.

🎯 Requirements

• High school diploma or equivalent; associate degree or business/healthcare coursework preferred. • 3-5 years of experience in medical billing, payment posting, or healthcare revenue cycle operations. • Strong knowledge of ERAs, EOBs, CPT/ICD-10 codes, and insurance payer processes. • Proficiency with billing systems (e.g., Epic, Athena, NextGen, eClinicalWorks, Kareo, etc.) and Excel/Google Sheets. • Excellent attention to detail, analytical skills, and ability to work independently with high accuracy. • Strong communication and problem-solving skills.

🏖️ Benefits

• Competitive compensation packages that reflect the value you bring. We reward our team for the impact of their work – full-time employees are eligible for an annual company performance bonus. • Comprehensive health coverage that works for you. Choose from high-quality medical dental and vision options, including a $0 deductible PPO and a company-funded HSA, alongside employer-paid life and disability insurance. • Generous paid time off. We provide policies that allow you to recharge along with 10 paid company holidays. • Financial savings benefits to support your future. We support your financial well-being with HSA contributions, optional FSA and commuter benefits, and full coverage of all 401(k) account fees (employer match not currently offered). • Paid parental leave to support your growing family. We provide paid leave, so you can focus on bonding and adjusting to life as your family grows.