Payment Associate

Primary Functions: 1. Payment Processing & Posting

• Post payments from insurance companies, government programs (Medicare/Medicaid), and patients into the RCM system.
• Process Electronic Remittance Advices (ERA) and manual Explanation of Benefits (EOB).
• Apply necessary adjustments, refunds, and write-offs per payer guidelines. • Balance and reconcile daily deposits with posted payments.

2. Denial Management & Reconciliation

• Identify and post insurance denials while ensuring timely follow-up for resolution. • Work with the billing and accounts receivable teams to correct claim errors and resubmit claims.
• Track underpayments and escalate discrepancies to the RCM Manager.

3. Reporting & Documentation

• Maintain accurate payment records and reconciliation reports.
• Generate daily, weekly, and monthly reports on payment trends, denials, and discrepancies.
• Ensure compliance with company policies and industry regulations (HIPAA, Medicare guidelines).