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Essential Job Functions
Review and reconcile electronic remittance advice (ERA) files, paper checks, credit card transactions, and other forms of payment received.
Accurately post payments to patient accounts using the appropriate billing software or database.
Identify and resolve any discrepancies or issues with posted payments, ensuring accuracy and adherence to regulatory requirements.
Work closely with insurance companies, patients, or third-party payers to resolve payment-related inquiries or disputes.
Process credit balance requests by identifying overpayments and initiating refunds according to company policies and procedures.
Maintain accurate and updated records of all payment transactions, credits, and refunds, including the completion of necessary documentation.
Stay up to date with industry trends, regulations, and changes in reimbursement practices to ensure payments, credits, or refunds.
Provide excellent customer service by promptly responding to any inquiries or requests related to payments, credits, or refunds.
Performs other duties as directed.
Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.
Key Success Indicators/Attributes
Excellent attention to detail and accuracy in data entry and record keeping.
Ability to prioritize and multi-task in a fast-paced, changing environment.
Demonstrate ability to work in all work types and specialties.
Demonstrate ability to self-motivate, set goals, and meet deadlines.
Demonstrate problem-solving skills and the ability to think critically to identify and implement appropriate solutions.
Demonstrate excellent verbal communication skills, with the ability to interact professionally with insurance companies, patients, and colleagues.
Strong active listening skills to understand patient concerns and provide appropriate resolutions.
Maintain courteous and professional working relationships with employees at all levels of the organization.
Work in accordance with corporate and organizational security policies and procedures, understand personal role in safeguarding corporate and client assets, and take appropriate action to prevent and report any compromises of security within scope of position.
Skill in operating a personal computer and utilizing a variety of software applications is essential.
Knowledge of JCAHO, coding compliance and HIPAA HITECH standards affecting medical records and the impact on reimbursement and accreditation is an added advantage.
Supervisory Responsibility
No
Work Environment
This job operates in a remote home office environment. This role routinely uses standard office equipment such as computers and phones.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.
Position Type/Expected Hours of Work
This is a full-time position. Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m. This position occasionally requires long hours and weekend work.
Travel
Minimal travel required; up to 5%
Required Education and Experience
Minimum of 1-2 years prior experience/knowledge of payment posting procedures, insurance claim processing, and billing practices. Familiarity with various payment methods, including electronic remittance advice (ERA), checks, credit cards, and online payment systems.
Proficient in using billing software and Microsoft Office Suite.
High School diploma or equivalent, additional education in healthcare administration or related field is a plus.
Proven experience in a customer service or call center role, preferably within the healthcare industry.
Preferred Education and Experience
N/A
Additional Eligibility Qualifications
N/A
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Employee may perform other duties as assigned.
Qualifications
General knowledge of bookkeeping, basic accounting, and familiarity with insurance industry practices.
General knowledge of CPT and ICD9 codes.
Strong analytical, organizational, and communication skills required.
Minimum of two years related work experience in a health care environment.
Demonstrated knowledge of managed care principles, insurance industry practices, and medical terminology required.
Excellent verbal and written communication skills necessary.
Ability to operate data entry equipment and related computer systems.
Typing skills of 40wpm.
Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visit www.omegahms.com
We offer a comprehensive benefits package that may include health, dental, and vision coverage, voluntary insurance options, a 401(k) plan with employer match, professional development opportunities, paid time off, and holiday pay. Eligible employees may also have the opportunity to participate in bonus programs, commissions, or other variable incentive plans. Benefits and incentive eligibility may vary based on position, location, and tenure.
AAP/EEO Statement
Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.
Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at employeerelationsus@omegahms.com.
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