Cash Applications Specialist

  • Job ID:

    2082

  • Pay rate range:

    $14/hr - $16/hr

  • City:

    Brockton

  • State:

    Massachusetts

  • Duration:

    11/17/2019 - 05/17/2020

  • Job Type:

    Contract

  • Job Description:

    Unapplied Cash – Associate I

    Responsible for reviewing unclaimed payments reversed or removed from claims and determine the appropriate action to reconcile the payment unclaimed by 3rd Party Payers.  This may include reconciling the payment to the claim if moved to Unapplied Cash in error or working with payers to identify claims that need to be reversed in order for the payment to be recovered by the payer (preferably via the electronic 835 process) and be removed from unapplied cash.  Associate will be required to follow all allocation and reconciliation of unapplied cash funds in accordance with Our Cash Processing Center’s Policy and Procedures and the Consumer Credit Protection Act of 1977.  

    Essential Functions:

    • Main function will be to evaluate older entries in Unapplied Cash – by payer groups – to determine a root cause issue that resulted in the claims payment to be moved to Unapplied Cash; especially those that have not been recouped by the payer. 

    • Associate will need to support and document the correct action needed to resolve UAC entries.  This may include determining if payments should be re-applied to claims or action taken to communicate with payers to take back funds.

    • Associate may need to initiate refunds, provide detailed spreadsheets, research Provider Line Balance or provide other information to 3rd Party payers that will result in a successful reconciliation of funds. 

    • Ensures cash is posted accurately and timely in accordance with the cash processing center standards through the AS400.

    • Researches and determines reasons and patterns of payments to unapplied cash accounts.

    • Communicates with 3rd Party Payers, vendors, collection centers, internal departments and potentially pharmacies to achieve appropriate posting or reconciliation of cash.

    • Tracks and reports daily and weekly productivity, as well as, maintains a tracking system to ensure communicated issues are resolved and completed timely.

    • Works with Department Manager in identifying any payer issues that may require special attention or need escalation.

    • Performs other tasks as assigned.

    • Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.

    To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required.  Each essential function is required, although reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    Position Qualifications:

    • Education/Learning Experience

    • Required: High School graduate, GED or equivalent experience

    • Desired: Associate’s Degree, Bachelor’s Degree

     

    • Work Experience

    • Required: 3 years 3rd Party billing, reconciliation, adjudication, etc

    • Desired: Third Party Billing or collections/billing experience in the healthcare industry

          AS-400 computer experience and banking or cash reconciliation experience

     

    • Skills/Knowledge

    • Required: Proficiency in MS Office Products (Excel, Word) and basic computer knowledge

    • Desired:

     

    • Licenses/Certifications 

    • Required:

    • Desired:

     

    • Behavior Competencies

    • Required: Communication, Problem Solving, Detail Orientation and Teamwork

    Desired:

    Physical Requirements:

     

    • Standing

     

    • Sitting

     

    • Walking

     

    • Lifting

     

    The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    #PHARMA, #PCFA

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