ABOUT WILMINGTON HEALTH

Since 1971, Wilmington Health has been committed to the care and health of our community in Wilmington as well as all of Southeastern North Carolina. Wilmington Health is structured as a multi-specialty medical practice with primary care providers integrated into the system. In this way, Wilmington Health is able to provide a comprehensive and coordinated approach to the care of all our patients. Wilmington Health is committed to using collaborative, evidence-based medicine in providing the highest quality of care to the patients we serve.

PURPOSE:

Applies all payments, adjustments, denials and requests for information received from the insurance carriers in the form of an Explanation of Benefit, Explanation of Payment, Remittance, as well as the payments from private parties, accurately to the patient account in the practice management system in a timely manner

ESSENTIAL DUTIES/RESPONSIBILITIES:

Applies transactions in practice management system via electronic or manual entry

Validates electronic remittance advice information prior to posting

Posts reason codes per the EOB on each line item

Ensures balance is correctly moved to the Next Responsible Party, i.e., secondary insurance, patient; prior to posting batch to practice management system

Balances each batch to the deposit amount prior to posting to practice management system

Ensures claims are accurately closed or re-opened as a result of a recoupment of payment

Applies logic and reason to identify and prevent trends and erroneous payments

Assists in identifying claims that are not paid according to negotiated contract

Balances payment and adjustment batches prior to posting to practice management system

Identifies and report reoccurring claim denials and erroneous payments

Maintains EFT records for clearing house-making sure that all remits are pulled off for the month and have been posted, including zero dollar ERAs

Maintains monthly deposit log, balancing payments posted daily

Identifies and initiates refund on overpayments created while posting

Begins refund process for deposited money not belonging to Wilmington Health

OTHER DUTIES:

As assigned by management

QUALIFICATIONS:

REQUIRED:

High school diploma or equivalent

Strong proficiency working in a Windows environment

Proficiency with Microsoft Office Suite (Excel, Word, Outlook)

ADA PHYSICAL DEMANDS:

Rarely (Less than .5 hrs/day)  Occasionally (0.6 – 2.5 hrs/day) Frequently (2.6 – 5.5 hrs/day) Continuously (5.6 – 8.0 hrs/day)

PHYSICAL DEMAND

REQUIRED?

FREQUENCY

Standing

Rarely

Sitting

Continuously

Walking

Rarely

Kneeling/Crouching

Rarely

Lifting

Rarely

Required Skills

POSTING ANALYST COMPETENCIES

GENERAL

1. Customer Service
2. Professionalism/Integrity/Responsibility
3. Teamwork/Process Focus
4. Dependability/Punctuality
5. Interpersonal Relationships/Communication
6. Judgment/Decision Making/Problem Solving
7. Quality/Quantity
8. Initiative
9. Safety/Housekeeping
10. Organizational Skills/Time Management

DEPARTMENT SPECIFIC

1. Maintains high level of keying accuracy
2. Sharp attention to detail
3. General math ability
4. Understanding of explanation of benefits
5. Understanding of acceptable non-contractual write offs
6. Strong computer skills including, but not limited to, spreadsheets, word processing, file transfers, file uploading/downloading, and accessing files online

Required Experience

POSTING ANALYST COMPETENCIES

GENERAL

1. Customer Service
2. Professionalism/Integrity/Responsibility
3. Teamwork/Process Focus
4. Dependability/Punctuality
5. Interpersonal Relationships/Communication
6. Judgment/Decision Making/Problem Solving
7. Quality/Quantity
8. Initiative
9. Safety/Housekeeping
10. Organizational Skills/Time Management

DEPARTMENT SPECIFIC

1. Maintains high level of keying accuracy
2. Sharp attention to detail
3. General math ability
4. Understanding of explanation of benefits
5. Understanding of acceptable non-contractual write offs
6. Strong computer skills including, but not limited to, spreadsheets, word processing, file transfers, file uploading/downloading, and accessing files online