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Location: Guaynabo PR
The Payment Reconciliation Specialist is responsible for performing complete reconciliation of payments from Health Plans, Foundations, and patients. Their role ensures that all payments received are validated, correctly applied in the billing systems, accurately documented, and reported in a timely manner. This role is critical to the financial integrity of the revenue cycle and to the operational compliance of the department.
Responsibilities:
- Perform electronic and manual reconciliation of payments for medical plans, foundations, and patient deductibles.
- Validate that the balances created in the secondary plans and patient lines are correct.
- Download 835 files, review portals, and process information as requested.
- Apply payments in the system and correctly document transactions made.
- Record all reconciled payments in the established systems.
- Review and document daily deposits sent by accounting.
- Obtain, scan, and file Explanations of Payment (EOP).
- Generate reconciliation reports and balance transaction totals.
- Timely deliver required explanations of payment to the Collections area.
- Request explanations of payments or additional evidence from medical plans as needed.
Requirements:
- Medical Billing Certification or equivalent to 2 years of billing experience.
***Equal Opportunity Employer M/F/V/D***
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