CHI Memorial Mountain Management Service CBO
Under general supervision, the Charge Capture Cash Posting rep is responsible for cash posting functions for the Memorial Health Partners Foundation (MHPF) including the review of patient encounters and corrections in accordance with applicable guidelines. Work also includes entering patient and insurance payments, contractual allowances and other adjustments onto the patient’s account and interpretation of Explanations of Benefits (EOBs)/Electronic Remittance Advice (ERAs) from insurance.
Work requires an understanding of detailed billing requirements, cash posting processes and government/commercial insurance reimbursement terms, remittance advice details and contractual/other adjustments. Attention to detail, the ability to accurately and timely troubleshoot/resolve (within position scope) issues that have a potential impact on revenues are also required.
Essential Key Job Responsibilities
- Conducts appropriate reviews using critical thinking skills to understand how to transfer payments.
- Reviews and posts payments and write-off/adjustments from insurance and patients. Reviews Explanation of Benefits (EOBs)/ Electronic Remittance Advice (ERAs), payments, adjustments, insurance contracts and contracting system, insurance benefits, and all account comments; applies knowledge of payer contracts and experience with insurance reviews to gather additional information as necessary. Posts and tracks electronic funds transfer (EFT) information and validates EFTs for accuracy. Follows write-off approval protocols for non-routine adjustments. Completes daily posting log and quarterly cash handling audits and reports findings to Supervisor.
- Identifies and researches unusual, complex or escalated issues as assigned; applies problem-solving and critical thinking skills as necessary to resolve issues within the scope of position authority or to escalate following established procedures. Notifies Supervisor/Manager of ongoing issues and concerns as appropriate.
- Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records. Meets quality assurance and productivity standards for timely and accurate posting of payments in accordance with organizational policies and procedures.
- Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function. Has knowledge of, and is compliant with, government regulations including "signature on file" requirements, compliance program, HIPAA, etc. Applies current knowledge of cash posting processes. Applies current knowledge of government/commercial insurance reimbursement terms, contractual and/or other adjustments and remittance advice details.
- Establishes and maintains professional and effective relationships with peers and other stakeholders. Establishes and maintains a professional relationship with clinics and FMG staff in order to resolve issues. Depending on role and Epic training, may be called upon to support other areas in the Revenue Cycle.
- Performs related duties as required.