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SBO Payment & Credit Analyst (Cash Application)


This is a Contract position in Seaford, DE posted October 31, 2021.

This position is accountable for processing Provider Level Adjustments (PLBs) received from insurance companies for Hospital and Physician payments and offsets. Reconciles PLBs and other undistributed payment transactions to patient accounts for the Medical Center, Bayhealth Medical Group and Medical Alternative Care. Ability to understand the ANSI electronic remittance file structure, including loops and segments within the file to properly resolve the transaction. Responsible for researching and resolving posting related cash credit balances that are not related to contract or billing discrepancies. Responsible for researching and resolving cash undistributed clearing accounts and work queues. Responsible for researching and resolving PLB accounts. Responsible for reviewing undistributed and other payment error queues to maintain unapplied cash and reconciling items at a minimum.

Minimum Education and Experience:

Associates Degree or an additional 4 years of banking, bookkeeping, or hospital physician payment processing experience

Three years experience in banking, bookkeeping or hospital and/or physician payment processing.

Five years experience in banking, bookkeeping or hospital and/or physician payment processing.

Computer/Software Knowledge:
Intermediate computer literacy and calculator experience. Intermediate Excel experience required. 10 key touch skills.
Experience with EPIC

Special Knowledge, Skills, and/or Abilities: Excellent analytical skills and strong attention to detail is required. Excellent ability to problem solve/reconcile cash transactions. Excellent organizational skills. High producer; performs all areas of job functions at a high accuracy rate. Understanding of electronic remittance advice (ERA/835) file formats and technical structure related to Provider Level Adjustments (PLBs). Intermediate experience in Microsoft Excel; demonstrated competency. Excellent math skill; ability to calculate fractions, decimals and percentages. Advanced interpersonal written and verbal communication skills; must demonstrate ability to articulate information in a clear and informative manner. Knowledge of revenue-cycle, managed care environment, 3 rd party reimbursement, and hospital financial resources desired. Knowledge of insurance payers. Must be proficient in reading, writing, and speaking English. Ability to read and interpret documents such as an Explanation of Benefits and/or Remittance Advice. Ability to use multiple windows/programs at one time. Ability to navigate payer websites to view and download explanation of benefits and remittance advice.

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