About Wilmington Health

Since 1971, Wilmington Health has been committed to the care and health of our community in Wilmington as well as all of Southeastern North Carolina. Wilmington Health is structured as a multi-specialty medical practice with primary care providers integrated into the system. In this way, Wilmington Health is able to provide a comprehensive and coordinated approach to the care of all our patients. Wilmington Health is committed to using collaborative, evidence-based medicine in providing the highest quality of care to the patients we serve.

Purpose:

Applies all payments, adjustments, denials and requests for information received from the insurance carriers in the form of an Explanation of Benefit, Explanation of Payment, Remittance, as well as the payments from private parties, accurately to the patient account in the practice management system in a timely manner

Essential Duties/Responsibilities:

• Applies transactions in practice management system via electronic or manual entry
• Validates electronic remittance advice information prior to posting
• Posts reason codes per the EOB on each line item
• Ensures balance is correctly moved to the Next Responsible Party, i.e., secondary insurance, patient; prior to posting batch to practice management system
• Balances each batch to the deposit amount prior to posting to practice management system
• Ensures claims are accurately closed or re-opened as a result of a recoupment of payment
• Applies logic and reason to identify and prevent trends and erroneous payments
• Assists in identifying claims that are not paid according to negotiated contract
• Balances payment and adjustment batches prior to posting to practice management system
• Identifies and report reoccurring claim denials and erroneous payments
• Maintains EFT records for clearing house-making sure that all remits are pulled off for the month and have been posted, including zero dollar ERAs
• Maintains monthly deposit log, balancing payments posted daily
• Identifies and initiates refund on overpayments created while posting
• Begins refund process for deposited money not belonging to Wilmington Health

Other Duties:

• As assigned by management

Qualifications:

Required:

• High school diploma or equivalent
• Strong proficiency working in a Windows environment
• Proficiency with Microsoft Office Suite (Excel, Word, Outlook)
• Full COVID 19 vaccination is required as a condition of employment for all position with Wilmington Health. Documentation is required prior to orientation.

Wilmington Health is an Equal Opportunity Employer committed to providing equal opportunities to all applicants and employees. We are committed to treating everyone equally and with respect regardless of race, age, sex, religion, national origin, citizenship, marital status, veteran’s status, sexual preference, disability, genetic information or any other class protected under state or federal law.

ADA Physical Demands:

Rarely (Less than .5 hrs/day) Occasionally (0.6 – 2.5 hrs/day) Frequently (2.6 – 5.5 hrs/day) Continuously (5.6 – 8.0 hrs/day)

Posting Analyst Competencies

General

• Customer Service
• Professionalism/Integrity/Responsibility
• Teamwork/Process Focus
• Dependability/Punctuality
• Interpersonal Relationships/Communication
• Judgment/Decision Making/Problem Solving
• Quality/Quantity
• Initiative
• Safety/Housekeeping
• Organizational Skills/Time Management

Department Specific

• Maintains high level of keying accuracy
• Sharp attention to detail
• General math ability
• Understanding of explanation of benefits
• Understanding of acceptable non-contractual write offs
• Strong computer skills including, but not limited to, spreadsheets, word processing, file transfers, file uploading/downloading, and accessing files online