"Alerted.org

Job Summary

The Insurance Payment Resolution Analyst is responsible for processing, reconciling, and balancing cash transactions to ensure accurate posting of payments and adjustments. This role involves analyzing payer reimbursements, resolving discrepancies, and maintaining compliance with company policies and regulatory requirements. The Insurance Payment Resolution Analyst also reviews health insurance payments, manages fund transfers, and ensures accuracy in patient account transactions while supporting process improvements in financial operations.

Essential Functions

+ Contact various payors for remittance advice or specific patient account information.

+ Receives, reviews, and preps batches for daily posting, ensuring transactions are accurate and correctly applied.

+ Posts insurance and non-insurance payments, including resolving edits, manually matching invoices, and balancing payment files against checks or electronic funds transfers (EFTs).

+ Analyzes payer reimbursements, comparing payments received against contract fee schedules to confirm appropriate adjustments and determine patient responsibility when applicable.

+ Processes and posts debit entries for approved refunds, ensuring compliance with company policies and financial guidelines.

+ Researches and transfers unidentified payments, applying established procedures to allocate funds correctly.

+ Ensures account balances are accurate, reviewing posted transactions and preparing batches for scanning into document imaging systems.

+ Maintains compliance with hospital policies, procedures, and regulatory requirements, ensuring adherence to HIPAA guidelines and financial controls.

+ Performs other duties as assigned.

+ Complies with all policies and standards.

Qualifications

+ H.S. Diploma or GED required

+ Associate Degree in Accounting, Finance, Business Administration, or a related field preferred

+ 2-4 years of experience in cash posting, accounts receivable, or payment processing required

+ Experience with healthcare revenue cycle, insurance reimbursement, or financial operations preferred

Knowledge, Skills and Abilities

+ Strong understanding of cash reconciliation, payment posting, and financial transaction balancing.

+ Experience with insurance remittance, contractual adjustments, and refund processing.

+ Proficiency in Microsoft Excel, financial reconciliation tools, and cash management software.

+ Ability to analyze and resolve discrepancies in financial transactions.

+ Excellent attention to detail, organizational skills, and ability to work under deadlines.

+ Strong verbal and written communication skills, with the ability to interact with finance teams, payers, and internal departments.

+ Knowledge of HIPAA and financial security regulations related to payment transactions and patient accounts.

Equal Employment Opportunity

This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.