Payment Posting Specialist

Groups is a leading outpatient provider specializing in substance use disorder (SUD) treatment. We are committed to supporting underserved communities hit hardest by the opioid crisis. Since 2014, our local care teams have guided hundreds of thousands of individuals on their path to recovery, helping them reclaim their purpose and dignity through compassionate, collaborative care.

Our evidence-based approach combines medication, group therapy, and personalized support, delivered online and in person by local providers. Founded on the belief that recovery extends beyond the traditional office visit, Groups helps members build a foundation for long-term recovery and the fulfilling lives they want and deserve. 

Together with our community partners, public agencies, and health plans, we are raising the bar in addiction health care—and we’re just getting started. 

Groups is changing lives. Join us.

The Payment Poster is responsible for accurately and efficiently posting all payments, adjustments, and denials from insurance companies and patients to the patient accounts in the billing system. This position ensures financial data integrity by managing and reconciling all payments to support the overall revenue cycle.

Essential Functions:

Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions.

• Post all payments from Remittance and EOB’s to appropriate accounts with minimum errors.
• Apply manual payments and auto payments to accounts for payor types of Medicare, Medicaid and Commercial Insurances.
• Analyze EOB information, including co-pays, deductible, co-insurance, contractual adjustments, denials and more to verify accuracy of patient balances.
• Add appropriate ANSI denial codes and comments to assure all necessary appeals and post payment follow up can take place.
• Investigate the source of unidentified payment to ensure they are applied to appropriate accounts. If necessary, will contact the sender to clarify where the payment should be posted.
• Reconcile shortage on both paper and electronic EOBs to determine proper allowance and correct write off.
• Assist in setting up Electronic Remittance Advices (ERA) for Commercial and Medicare payors
• Send all batch reconciliation information to the Finance department.
• Follow up with outstanding A/R all payers and/or including self-pay and/or including resolution of denials.

Other Duties and Responsibilities:

• Other duties as assigned.

Knowledge, Skills and Abilities:

• Knowledge of CPT, HCPCS, ICD-10 coding, and payer rules related to behavioral health services.
• Knowledge of insurance plans, policies, and procedures.
• Proficiency in using EHR systems and insurance verification software.
• Understanding of payment reconciliation and basic accounting practices.
• Proficiency in Zoom/Google Meets and other virtual meeting platforms
• Strong organizational and multitasking skills.
• Excellent verbal and written communication skills.
• Detail-oriented with a high level of accuracy.
• Ability to handle sensitive member and payment data in compliance with regulatory standards.
• Ability to use discretion and work independently under general supervision.
• Ability to work as part of a team.
• Ability to understand and adhere to the Professional Code of Conduct.

Qualifications & Requirements:

• High school diploma or equivalent associate's degree or relevant certification preferred.
• Minimum of 2-5 years of experience in posting payments from Remittance and EOB’s as well as applying manual payments
• Access to reliable internet and telephone services, specifically 40M download and 10M upload package or higher as well as a strong WiFi signal from your remote work location.
• Must meet pre-employment requirements and maintain all applicable state and job-related guidelines for background screening.  

Physical Requirements & Working Conditions:

These physical demands are representative of the physical requirements necessary for an employee to successfully perform the essential functions of the job. Reasonable accommodation can be made to enable people with disabilities; these are made on a case-by-case basis.

While performing the responsibilities of the role, the employee is required to talk and hear. The employee is often required to sit and use his or her hands and fingers.  The employee is occasionally required to stand, walk, and reach with arms and hands. Vision abilities required by this job include close vision.

Limitations and Disclaimer:

The above job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties and skills required for the position.  Other duties may be assigned from time to time.

Equal Employment Opportunity Statement:

Groups is an equal opportunity employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision.