Payment Posting Specialist (RCM)

CF Solutions Philippines Inc.; Quezon City; On-site; PHP 240,000 - 360,000; Full time

Job summary

CF Solutions Philippines Inc. is seeking a detail-oriented Medical Billing Payment Posting specialist in the Metro Manila area. The role requires posting insurance and patient payments, ERAs, EOBs, and adjustments with accuracy and speed, while ensuring proper balance transfers per COB rules.

Responsibilities include bank reconciliation, month-end close, and handling denials and takebacks. Proficiency in Excel and experience with EHR systems are essential for timely, compliant postings.

Qualifications

• Minimum 2 years of medical billing payment posting experience.
• Experience with EHR/Practice Management systems and clearinghouses.
• Strong understanding of ERAs, EOBs, allowed amounts, contractual adjustments, sequestration, and balance transfers.
• Knowledge of Medicare, Medicaid, commercial insurance, and coordination of benefits.
• Proficiency in Excel with strong analytical skills and attention to detail.

Responsibilities

• Post insurance and patient payments, ERAs, EOBs, adjustments, denials, and zero-pay remittances within 24–48 hours.
• Verify payer allowed amounts and apply contractual adjustments; identify reimburse­ment discrepancies.
• Apply payments, deductibles, copays, and coinsurance; transfer remaining balances per COB guidelines.
• Validate sequestration reductions, payer offsets, and adjustments to ensure correct posting.
• Reconcile daily payment batches against bank deposits, EFTs, checks, and lockbox reports.
• Prepare month-end reconciliation reports for payments, deposits, unapplied cash, and discrepancies.
• Review payer recoupments, offsets, and reversals; track recoveries.
• Compare payments against contracted rates to identify underpayments.
• Review insurance and patient credits; prepare refund documentation for approval.
• Attach EOBs and payer letters to accounts and route correspondence within 24 hours.
• Post denials and zero-pay claims with correct codes; route follow-ups to AR team.
• Maintain daily productivity and reconciliation reports; escalate unresolved issues.

Skills

Excel proficiency

Analytical skills

Attention to detail

Time management

Tools

EHR/Practice Management systems

Clearinghouses

Job description

Job Summary:

Responsible for accurate and timely posting of insurance and patient payments, bank and lockbox

reconciliation, payer takebacks, fee schedule verification, credit balance research, and payment related correspondence. Ensures accurate payment allocation, contractual adjustments, and account balances

Key Responsibilities:

• Payment Posting: Post insurance and patient payments, ERAs, EOBs, adjustments, denials, and zero-pay remittances within 24–48 hours.
• Allowable & Contractual Adjustments: Verify payer allowed amounts, apply accurate contractual adjustments, and identify reimbursement discrepancies based on payer contracts and fee schedules.
• Payment Allocation & Balance Forwarding: Accurately apply payments, deductibles, copays, and coinsurance. Transfer remaining balances to secondary insurance or patient responsibility according to coordination of benefits and payer guidelines.
• Sequestration & Other Adjustments: Validate Medicare sequestration reductions, payer offsets, and other adjustments to ensure correct posting without incorrectly increasing patient responsibility
• Bank Reconciliation: Reconcile daily payment batches against bank deposits, EFTs, checks, and lockbox reports. Identify and resolve variances.
• Month-End Reconciliation: Prepare reconciliation reports for payments, deposits, unapplied cash, and outstanding discrepancies.
• Takeback Reconciliation: Review payer recoupments, offsets, and reversals. Validate amounts against original payments and track outstanding recoveries.
• Fee Schedule Verification: Compare payments against contracted rates or expected reimbursement to identify underpayments and incorrect adjustments
• Credit Balance Research: Review insurance and patient credits, identify true overpayments versus posting errors, and prepare refund documentation for approval
• Correspondence Management: Review, index, and attach EOBs, payer letters, and payment documents to the appropriate accounts. Route correspondence within 24 hours
• Denial Posting: Post denials and zero-pay claims with accurate adjustment and remark codes, document denial reasons, and route claims requiring follow-up to the AR team.
• Quality Control & Reporting: Review posting accuracy, payment allocation, and account balances. Maintain daily productivity and reconciliation reports and elevate unresolved discrepancies.

Qualifications:

• Minimum 2 years of medical billing payment posting experience preferred.
• Experience with EHR/Practice Management systems and clearinghouses
• Strong understanding of ERAs, EOBs, allowed amounts, contractual adjustments, sequestration, and balance transfers.
• Knowledge of Medicare, Medicaid, commercial insurance, and coordination of benefits.
• Experience with bank reconciliation, credit balances, payer recoupments, and fee schedules.
• Proficiency in Excel with strong analytical skills and attention to detail.

Performance Expectations:

• Posting Accuracy: 98% or higher.
• Payment Posting: Within 24–48 hours.
• Bank & Batch Reconciliation: Daily, with discrepancies documented.
• Correspondence Routing: Within 24 hours.
• Credit Balance Research: Within 30 days, prioritizing regulatory deadlines.
• Takebacks & Underpayments: Timely identification, tracking, and escalation.
• Month-End Close: Complete assigned reconciliations and reporting by established deadlines.