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Payment Application Specialist - PFS - RCSSD

San Diego, California
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Job ID 15176 Date posted 09/23/2024 Schedule Full-Time Shift Day Department Patient Financial Services

JOB SUMMARY:

The Payment Application Specialist researches, audits, reconciles and applies all cash receipts to AR accounts. Is skilled at researching, auditing, and reconciling payments for the respective departments. Is able to interpret explanations of benefits (EOBs) and reconcile and apply payments, recoupments, and provider level adjustments (PLBs). Identifies external payments and non-patient payments, and takes proper steps to transfer to the appropriate entity/general ledger account using designated adjustment codes. Processes payments and denials with the correct denial/remittance codes and applies denials/payments to the appropriate account/liability bucket. Handles processing of Non-Sufficient Funds (NSF) payments. Conducts in-depth research to resolve any balancing issues or to reconcile unidentified payments posted to clearing accounts. Identifies issues with ERAs/contractual calculations/payer compliance and escalates appropriately. Uses system generated reports, performs in-depth research and reconciliation of variances in the internal balancing tool. Recognizes and shares areas for process improvements. Is considered a subject matter expert (SME) in multiple areas of payment application and trains team members/documents processes/participates in workflow testing and other projects in order to improve the overall knowledge and function of their team. Performs other duties as assigned.

MINIMUM QUALIFICATIONS:

H.S. Diploma,GED,or Equivalent

2 Years of Experience

PREFERRED QUALIFICATIONS:

5 Years of Experience

One year college (accounting courses) or equivalent education/experience.

The expected hiring range for this position is $23.10 to $31.77

Rady Children’s Hospital is committed to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity. This posting will remain open from the “date posted” until the hiring manager has determined there is a sufficient applicant pool or until the position is filled.

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