*CBO Payment Applications Specialist/Full Time/Hybrid

GENERAL SUMMARY:

The Payment Applications Specialist is responsible for accurately posting payments received from patients and third-party payers to healthcare accounts receivables across a multi-facility integrated healthcare delivery system. This includes managing billing associated with Henry Ford Health System hospitals, outpatient clinics, and employed physicians.

PRINCIPLE DUTIES AND RESPONSIBILITIES:
1. Post and balance patient payments received through various methods such as check, EFT, and credit card.
2. Post and balance payments received from third-party payers, applying related contractual adjustments and determining patient responsibility.
3. Post and balance payments received from collection agencies via electronic payment files.
4. Utilize automation processes to balance and post EFTs.
5. Balance and reconcile 835 Remittance files following proper work queue procedures to address remittance file errors and PLBs.
6. Resolve aged deposits to ensure proper application of payments or return of funds to the appropriate party.
7. Understand and apply HFH third-party insurance contract terms to appropriately apply contractual adjustments.
8. Analyze payer denial reasons to appropriately determine insurance responses based on adjudication using standard ANSI remittance codes.
9. Retrieve remittance files from payer websites and upload to document retention software.
10.Research and process misapplied or missing payments following proper work queue procedures.
11.Review and analyze unposted 835 remittance file activity and make recommendations on proper resolution.
12.Process refunds resulting from payments received in error.
13.Handle credit card chargebacks and items returned for nonsufficient funds.
14.Meet established quality and productivity expectations.
15.Identify and report any potential issues to leadership.
16.Adhere to legal and ethical standards as set forth in the HFH Code of Conduct.
17.Perform other related duties as assigned