Reconciliation Specialist / In Office

Job Purpose

This position will be located in the Plano Office and will provide support services for all 15 locations. The position will report directly to the Chief Financial Officer. The Reconciliation Specialist is responsible for performing manual and electronic posting functions for all Managed Care and Commercial plans, reconciliation of bank deposits, and process medical records requests. Follows standard procedures and pre-established guidelines to complete tasks.

Texas Retina Associates is Texas’ largest, most experienced ophthalmology practice focused specifically on the diagnosis, medical and surgical management of diseases of the retina and vitreous. Our fellowshipped and specialty trained physicians care for the most complicated retina conditions such as ocular cancer and uveitis. This physician owned medical group provides services at 15 locations throughout the DFW metroplex, Waco, Wichita Falls and Lubbock.

Essential Duties

Responsible for the timely and accurate posting of payments.

Assists customer service representatives with payment issues and researches missing payments and / or misapplications for both operating regions.

Maintain credit balances of patients and payors ensuring timely refunds within government guidelines/regulations.

Posts adjustments to customers’ accounts as needed.

Accurately apply payments, process refunds or re-submit accounts as needed

Efficiently process incoming paperwork utilizing department resources as needed

Provides notification of daily activity to accounting for reconciliation purposes

Must be able to meet strict posting deadlines to ensure that Manager can complete monthly reporting requirements

Identify patterns and trends that indicate a potential issue

Review reports, researches and resolves issues.

Review payment postings for accuracy and ensure account balances are current.

Participate in the implementation of procedures to improve the quality of work being processed.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below represent the knowledge, skill and /or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

Minimum Education and Experience

2 years of Outpatient Clinic Payment Posting

Experience with NextGen (EMR) is preferred

Knowledge of payer contracts and (EOBs), explanation of benefits

Experience working in a clearinghouse

Understanding of HIPAA regulations

Strong verbal and written skills

Must have great attention to detail and avoid data entry errors

Excellent communication skills

Must have strong organizational skills and effective time management

A positive, open and friendly attitude to colleagues and clients

Superior customer service and professionalism

Skills and Specifications

Work under minimum supervision and demonstrate strong initiative. Make independent decisions when circumstances warrant; make prompt and accurate judgments.

Excellent communication with physicians, patients and staff is required.

Must be articulate in English speech, writing and understanding.

Strong ability to listen, answer all questions as simply as possible and take action when needed to resolve issues.

Excellent organization skills; solid attention to detail to ensure accuracy of information

Proven analytical skills; recognize, evaluate, solve problems, and correct errors, and develop processes that eliminate redundancy

Use independent judgement to escalate issues to manager, as necessary.

Must be willing to work under pressure.

Excellent Microsoft Office Suite skills including Excel, Word, Outlook and Access

Attend work as scheduled and/or required.

Complete all other duties as assigned.

Physical Requirements

Sedentary with prolonged sitting, talking and working at computer.

Hear and use hands and fingers to operate and handle keyboards and controls

Occasionally required to walk, bend and reach with hands and arms

Must be able to lift up to occasionally lift, carry and/or move up to 25 pounds. Specific vision abilities include close vision and the ability to adjust focus.