Payment Poster

Xtensys; Knoxville (TN); Remote; USD 24,000 - 36,000; Full time

Job summary

Xtensys is a fast-growing MSP delivering technology solutions to health systems. The Payment Poster role supports revenue cycle by posting and reconciling insurance and patient payments from ERAs, EOBs, and remittances, while resolving discrepancies with strong attention to detail.

Remote work arrangement with Eastern Time alignment and ongoing HIPAA-compliant practices. Candidates should have healthcare billing experience, Excel proficiency, and familiarity with practice management systems.

Qualifications

• High school diploma or GED required; associate’s degree preferred.
• Experience with healthcare billing and revenue cycle systems.
• Strong attention to detail and data accuracy.

Responsibilities

• Post insurance and patient payments and adjustments accurately using ERA, EOBs, and manual remittance.
• Balance patient accounts by applying payments per remittance details and payer rules.
• Validate ERA files before posting and resolve posting issues.
• Identify and resolve payment discrepancies and variances.
• Apply CARC/RARC codes and document comments for resolution.
• Process payments from lockbox and other sources for timely cash application.
• Reconcile daily deposits with ERA files and reports.
• Maintain work queues and reports to ensure timely resolutions.
• Document account activity clearly for compliance and follow-up.
• Ensure postings meet policies, audit standards, and payer requirements.

Skills

Attention to detail

Accountability for performance

Verbal and written communication

Multitasking in fast-paced environment

Proficiency in billing systems

Microsoft Excel

Revenue cycle technologies

Education

High School Diploma or GED

Associate’s degree in related field (preferred)

Tools

Epic experience

Job description

Who We Are

Xtensys is a rapidly growing managed service provider delivering innovative technology solutions to health systems, beginning in New York and expanding nationwide. Owned by two industry leaders with a strong focus on advancing rural and community healthcare, Xtensys is executing several major initiatives and scaling quickly. With a team of more than 500 professionals, we are building a people‑centered culture rooted in collaboration, innovation, and strategic thinking.

How We Work:

East Coast Alignment: Our core operational and collaboration hours follow the Eastern Time Zone (ET), keeping our workflows synchronized with our primary clients and systems.

Why Join Us?

Mission‑Driven Work: You are the "bridge" ensuring technology serves health systems and their patients when they need it most.

Autonomy & Ownership: We trust you. You’ll lead projects, define success, and manage complexities with total support.

A Culture of Innovation: Have a fresh perspective? We want it. We encourage risk‑taking and continuous improvement.

Continuous Growth: We fuel your "restless curiosity" with opportunities to expand your skillset and mentor others.

Job Requisition:

Work Arrangement: Remote

Compensation Range: $17.55 - $26.33 per hour

The Role / Your Mission:

The Payment Poster position is responsible for ensuring accurate and timely posting, reconciliation, and balancing of insurance and patient payments to support optimal revenue cycle performance and financial integrity. This role drives accurate account resolution through effective processing of electronic and manual remittances, proactive identification and resolution of payment discrepancies, and maintenance of audit‐ready documentation. Success in this position requires strong knowledge of explanation of benefits (EOBs), patient accounting, payment posting workflows, and practice management systems, coupled with exceptional attention to detail, analytical skills, and a commitment to accuracy and customer service.

What You’ll Do Day-to-Day:

Payment Posting, Reconciliation and Resolution

Ensure all insurance and patient payments and adjustments are accurately posted using electronic remittance advice (ERA), EOBs, and manual remittance documentation.

Maintain accurate patient account balances by applying payments and adjustments in accordance with remittance details, payer requirements, and system posting guidelines.

Validate ERA files prior to posting to ensure completeness and identify issues that could impact posting accuracy or downstream workflows.

Resolve routine remittance file issues and upscale complex discrepancies to support timely and accurate payment processing.

Apply appropriate CARC and RARC codes and standardized account comments to facilitate claim resolution and reporting.

Retrieve and process payments from lockbox and other payment sources to ensure timely cash application.

Reconcile daily deposits against ERA files, lockbox reports, and other payment sources to maintain balanced and accurate financial records.

Identify, investigate, and elevate payment variances, missing remittances, unapplied cash, posting errors, and unbalanced batches to ensure timely resolution.

Conduct research using payer portals, clearinghouses, and available resources to locate missing payment information and supporting documentation.

Maintain assigned work queues and exception reports to ensure payments and posting discrepancies are resolved within established timeframes.

Document account activity clearly and accurately to support compliance, transparency, and follow‑up actions.

Ensure all payment posting activities meet organizational policies, audit standards, and payer requirements.

Consistently achieve established productivity, quality, and accuracy benchmarks.

Support revenue cycle operations by assisting with additional functions and adapting to changing workflows and business needs.

Collaboration & Issue Resolution

Partner with operational teams to promptly resolve payment‑related inquiries and posting issues.

Coordinate with appropriate departments and senior team members to address complex payment scenarios, recoupments, refunds, and correction requests.

Contribute to efficient cash flow management by facilitating timely communication and issue resolution across teams.

Compliance & Professional Development

Maintain current knowledge of healthcare billing regulations, payer requirements, reimbursement methodologies, and organizational policies.

Participate in ongoing education and training to ensure consistent application of industry best practices and payment posting standards.

Protect patient confidentiality and ensure compliance with HIPAA and all applicable regulatory requirements.

Who You Are & What You’ll Bring:

• Strong attention to detail and organizational skills with a commitment to data accuracy and financial integrity.
• Demonstrated accountability for meeting performance, productivity, and quality standards.
• Effective written and verbal communication skills with the ability to interact professionally across diverse populations and departments.
• Ability to prioritize and manage multiple responsibilities in a fast‐paced environment.
• Proficiency in practice management systems, billing applications, Microsoft Excel, and other healthcare revenue cycle technologies.
• Working knowledge of medical billing, insurance reimbursement, payment posting, and patient accounting processes.
• Strong analytical and problem‐solving skills with the ability to identify and resolve payment discrepancies.
• Ability to remain professional and effective under pressure while managing competing priorities.
• Understanding of HIPAA requirements and patient confidentiality standards.
• Ability to exercise sound judgment, collaborate effectively, and support positive team outcomes.
• Perform additional duties and responsibilities as assigned to support organizational goals.

Education:

High School Diploma or GED is required. Preferred: Associate’s degree in a related field and Epic experience is preferred.

Certifications:

None required.

Proven Track Record:

Associate’s degree plus 2 years of billing experience in a hospital billing environment, or High School Diploma plus 3 years’ experience in a hospital billing environment.

Physical Readiness:

Ability to perform the essential functions of the position with or without reasonable accommodation.

Travel Requirements:

Minimal, less than 10%

About Xtensys Connected Health Solutions

We are new but mighty. Xtensys, a recently established managed service provider, delivers cutting‐edge technology to health systems, starting in NY and expanding beyond. Owned by two industry leaders focused on innovation in rural and community health, we are rapidly growing with several major initiatives underway. We seek talented professionals to join our team of 500 and support our exciting journey. We value people and are building a culture to match. If you’re a collaborative, innovative, and strategic leader, we’d love to talk.

About Xtensys Connected Health Solutions

We are new but mighty. Xtensys, a recently established managed service provider, delivers cutting‐edge technology to health systems, starting in NY and expanding beyond. Owned by two industry leaders focused on innovation in rural and community health, we are rapidly growing with several major initiatives underway. We seek talented professionals to join our team of 500 and support our exciting journey. We value people and are building a culture to match. If you’re a collaborative, innovative, and strategic leader, we’d love to talk.