Payment Poster

Allegiance Mobile Health; Austin (TX); Remote; USD 42,000 - 64,000; Full time

Job summary

Allegiance Mobile Health is seeking a remote Payment Poster to accurately post insurance, patient, and third-party payments and adjustments to ground ambulance accounts as part of the Revenue Cycle team.

The role requires handling ERA/835 files, EOBs, batch posting, and reconciling cash to deposits, while maintaining PHI security in a fully remote work environment.

Qualifications

• High School Diploma required.
• Associate degree preferred.

Responsibilities

• Post payments, adjustments, and denials from ERA/835 and paper EOBs to the correct accounts.
• Process checks, lockbox files, EFT/ACH deposits, card payments and apply to accounts.
• Post payer adjustments and remittance elements by type (CO-45, CO-253, PLB).
• Review CARCs and RARCs to flag denials for follow-up.
• Prepare and upload credit/import batch posting files and verify postings.
• Reconcile daily/monthly cash to deposits and ERA totals; resolve variances.
• Research misapplied or unapplied payments and move between accounts with proper documentation.
• Identify overpayments and issue refunds/recoupment documentation for manager approval.
• Post remittances from collection agencies and other third parties per procedures.
• Apply adjustments within authority; escalate others to management.
• Track posting activity by payer and report issues to manager.
• Provide clear documentation in billing system and maintain PHI security.
• Use remote collaboration tools and report connectivity issues.

Skills

Attention to detail

Medicare/Medicaid knowledge

CARCs/RARCs knowledge

PHI security

Remote work tools

Excel advanced

Education

High School Diploma

Associate degree preferred

Tools

Billing software

Excel

EHR systems

Practice management software

VPN access

Job description

WHY JOIN ALLEGIANCE MEDICAL ENTERPRISES?

At Allegiance Medical Enterprises, our employees play an important role in supporting the patients, communities, and healthcare partners we serve.

We believe every role makes a difference. Whether you're providing patient care, supporting emergency operations, coordinating transportation, or keeping our organization running behind the scenes, your contributions help us deliver dependable, high-quality service every day.

We offer opportunities to learn, grow, develop new skills, and build a rewarding career while working alongside a team committed to making a difference.

If you're dependable, motivated, and looking for an opportunity to grow with an organization where your work matters, we encourage you to apply.

Join the Allegiance team and make a difference!

This position is responsible for the accurate and timely posting of insurance, patient, and third -party payments, adjustments, and refunds to ground ambulance accounts in support of the Revenue Cycle department, performed in a fully remote work environment. The Payment Poster processes electronic and paper remittances, reconciles posted cash to deposits, and ensures that denials, underpayments, credits, and recoupments are correctly identified and routed for follow-up. This role requires strong organizational skills, the ability to work independently, manage time effectively, and maintain the confidentiality and security of protected health information (PHI) while working remotely.

SUMMARY: This position is responsible for the accurate and timely posting of insurance, patient, and third -party payments, adjustments, and refunds to ground ambulance accounts in support of the Revenue Cycle department, performed in a fully remote work environment. The Payment Poster processes electronic and paper remittances, reconciles posted cash to deposits, and ensures that denials, underpayments, credits, and recoupments are correctly identified and routed for follow-up. This role requires strong organizational skills, the ability to work independently, manage time effectively, and maintain the confidentiality and security of protected health information (PHI) while working remotely.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Posts payments, contractual adjustments, and denials from electronic remittance advice (ERA/835) files and paper EOBs to the correct patient account, claim, and service line, including transport and mileage HCPCS codes.
• Processes checks, lockbox files, EFT/ACH deposits, credit card payments, and patient payments, and applies each to the correct account and payer.
• Posts payer adjustments and remittance elements accurately by type, including contractual (CO-45), sequestration (CO-253), patient responsibility, interest, and provider-level balance (PLB) recoupments or takebacks.
• Reviews claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs) on each remittance, and flags denials, underpayments, zero pays, and rejected lines for follow-up with clear documentation.
• Prepares and uploads credit import and batch posting files for manual and bulk posting and verifies that every file posts completely and accurately.
• Reconciles daily and monthly posted cash to bank deposits, ERA totals, and check amounts; investigate and resolve variances and out-of-balance batches.
• Researches and corrects misapplied, unapplied, and suspense payments, and move payments between accounts as needed with proper documentation.
• Identifies overpayments, duplicate payments, and credit balances; prepares refund requests and recoupment documentation and routes them for manager approval.
• Posts remittances from collection agencies and other third parties, including agency fees and write-offs, according to company procedures.
• Applies adjustments and write-offs only within approved authority levels and routes all others to management for approval.
• Tracks payment, denial, and underpayment activity by payer, identifies recurring posting and payer remittance issues, and communicates findings to their manager.
• Provides clear, timely documentation of all posting activity within the billing system and maintains accurate electronic records of remittances and batches.
• Follows applicable HIPAA requirements and company privacy and security policies when accessing, using, and disclosing protected health information (PHI), including maintaining a secure remote work environment and utilizing company-approved systems for handling PHI.
• Utilizes remote collaboration tools (video conferencing, instant messaging, shared dashboards) to stay connected with the billing team and management and proactively communicates any connectivity or equipment issues that may affect productivity.
• Performs other related duties and responsibilities as assigned.

KNOWLEDGE AND SKILLS:

• Strong attention to detail, accuracy, and numerical aptitude, with continuous focus on quality.
• Working knowledge of Medicare, Medicaid, Medicare Advantage, and commercial payer remittance formats, including ERA/835 and EOB layouts.
• Demonstrates knowledge of claim adjustment reason codes (CARCs), remittance advice remark codes (RARCs), and group codes (CO, PR, OA, PI).
• Understanding of ground ambulance billing, including HCPCS service and mileage codes and how payments and adjustments are applied at the line level.
• Proficient with computers, office equipment, and standard billing/practice management software; advanced Excel skills for reconciliation and file preparation preferred.
• Experience with bank deposit reconciliation, batch balancing, and cash application controls.
• Proficient in using remote work technologies, including VPN access, video conferencing, secure messaging, and cloud-based document sharing.
• Clear written and verbal communication skills, including professional phone and video etiquette.
• Demonstrates the ability to work independently, meet daily posting and balancing deadlines, and remain self-motivated and productive in a remote work environment.
• Basic awareness of cybersecurity best practices and data privacy requirements associated with handling PHI outside of a traditional office.

REMOTE WORK REQUIREMENTS:

• Must maintain a private work environment that supports the confidentiality and security of protected health information (PHI), in accordance with company policies and HIPAA requirements.
• Must have reliable internet connectivity sufficient to access company systems, process billing transactions, and participate in virtual meetings.
• Must utilize company-approved equipment, systems, and security measures, including VPN access, multi-factor authentication, and secure transmission of billing information.
• Must meet established work schedules, performance expectations, and communication requirements, including participation in scheduled virtual meetings and collaboration with team members and management.

PHYSICAL REQUIREMENTS:

• Regular use of a computer, keyboard, and other standard office equipment to perform payment posting, data entry, and reconciliation responsibilities.
• Ability to perform computer-based work and communicate with team members and management through appropriate communication methods.
• Work is primarily performed in a remote office environment and involves periods of computer-based activity throughout the workday.
• Essential functions of the position must be performed with or without reasonable accommodation.

MINIMUM QUALIFICATIONS:

• High School Diploma required; Associate degree preferred.
• Minimum of one year of experience in medical payment posting, cash application, or accounts receivable; ground ambulance or EMS billing experience preferred.
• Experience processing electronic remittance advice (ERA/835) and manually posting payments from explanation of benefits (EOB) statements required.
• Prior remote or telecommute position preferred.
• Working knowledge of electronic health record (EHR) and practice management systems, payer portals, and clearinghouse platforms.

Allegiance Mobile Health is an equal opportunity employer committed to providing a workplace free from discrimination and harassment. We consider qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other status protected by applicable federal, state, or local law. We are committed to providing reasonable accommodation to qualified individuals with disabilities throughout the employment process.