Job Summary
The Payment Posting Specialist is responsible for accurately posting insurance payments, contractual adjustments, and denials to patient accounts while ensuring billing accuracy and timely account updates. The role supports revenue cycle operations by reviewing EOBs and ERAs, resolving payment discrepancies, maintaining clean accounts receivable, and collaborating with billing and AR teams to support claim resolution. Experience with Behavioral Health services, including Mental Health and Substance Use Disorder (SUD) services, is required.
Screening Criteria
- High school diploma or equivalent.
- Minimum of one (1) year of healthcare revenue cycle, payment posting, medical billing, or related experience.
- Behavioral Health experience is required, preferably supporting Mental Health and/or Substance Use Disorder (SUD) services.
- Experience reviewing EOBs/ERAs, posting insurance payments, contractual adjustments, and denials.
- Must have stable employment history.
Job Description
- Post insurance payments, contractual adjustments, and denials accurately to patient accounts.
- Review and interpret EOBs and ERAs from commercial and government payers.
- Process and post payments related to Behavioral Health services, including Mental Health and Substance Use Disorder (SUD) services.
- Apply appropriate payment, adjustment, and denial codes based on payer information.
- Identify and resolve payment discrepancies, underpayments, and posting variances.
- Review patient accounts to ensure payment posting accuracy and completeness.
- Identify posting errors, payer inconsistencies, and billing issues for escalation.
- Maintain accurate documentation of payment-related activities and account updates.
- Collaborate with AR teams, billing teams, and supervisors to support claim follow-up and resolution.
- Research billing and posting questions using payer guidelines, internal references, and available resources.
- Ensure accurate payment posting based on Behavioral Health payer requirements and applicable levels of care.
- Support process improvement initiatives and special projects as assigned.
- Maintain compliance with HIPAA requirements, payer regulations, and internal billing procedures.
- Protect confidential patient and billing information.
- Follow established workflows and quality standards to ensure accurate revenue cycle operations.
Qualifications
- Knowledge of insurance payment posting, contractual adjustments, and denial codes.
- Experience with Behavioral Health billing and/or revenue cycle processes, including Mental Health and Substance Use Disorder (SUD) services.
- Proven ability to accurately review financial and billing information with strong attention to detail.
- Proven ability to manage multiple accounts and meet productivity expectations.
- Demonstrates strong understanding of healthcare billing and revenue cycle processes.
- Knowledge of Behavioral Health services, payer requirements, and billing practices is highly preferred.
- Demonstrates strong analytical and problem-solving skills to identify posting discrepancies.
- Clear and coherent written and verbal communication skills in English.
