Payment Specialist Job Description
Payment Specialist Duties & Responsibilities
To write an effective payment specialist job description, begin by listing detailed duties, responsibilities and expectations. We have included payment specialist job description templates that you can modify and use.
Sample responsibilities for this position include:
Payment Specialist Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Payment Specialist
List any licenses or certifications required by the position: IRA, FDCPA, CISM, CISA, CISSP, TARGET2, CPC, OS, PCI, ISA
Education for Payment Specialist
Typically a job would require a certain level of education.
Employers hiring for the payment specialist job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Healthcare, Auditing, Accounting, Education, Business, Finance, Associates, Business/Administration, Pharmacy, Economics
Skills for Payment Specialist
Desired skills for payment specialist include:
Desired experience for payment specialist includes:
Payment Specialist Examples
Payment Specialist Job Description
- Follow up on all suspended payments for secondary payors
- Input payments and SWIFT messages
- Calculates, adjusts, and processes compensation/ commission payments for agents and brokers in an accurate and timely fashion
- Receives and responds to inquiries and complaints from the agents and brokers regarding payments
- Provides periodic and ad hoc reporting, referring complex inquiries to higher level personnel
- Analyzes and reconciles simple to moderately complex discrepancies, which require the collection and review of payment histories to locate missing payments and/or locate errors
- Performs monthly and quarterly manual compensation reconciliations
- Provide extraordinary service to customers over the phone in a fast-paced contact center environment
- Listen and seek to understand the customer’s true need to create thoughtful solutions
- Overcome customer challenges and assist with negotiating payment solutions that our company offers
- Good computer skills (Imaging experience is a plus)
- Hours for this position are dayshift –Monday-Friday
- You must be willing to work overtime
- High School diploma and a minimum of 3 years of customer service experience
- Must have at least 2 + year’s knowledge of healthcare related experience (direct claim processing/reimbursement, medical facility contracts, fee schedules, inpatient/outpatient/physician claims)
- High School Diploma with previous cash handling or banking experience
Payment Specialist Job Description
- Researches and responds to routine and complex account inquiries and takes appropriate action
- Researches and responds to routine account inquiries and takes appropriate action according to SOPs
- Quality checks, reviews, and evaluates work completed by junior personnel for accuracy and timeliness
- Interfaces with Accounts Payable and other teams within the Membership Administration department
- Reviewing and making decisions regarding the items listed on Cash Pending, Partial Payment, and Overpayment reports in a timely matter
- Reviewing and making decisions based on established guidelines regarding unclaimed Membership checks
- Posts/inputs information to Company records through automated system
- Maintain complex for Program Design and Payment Programs and implement continuous improvements and solutions
- Monitor industry trends and benchmarks for Program Design and Payment Programs in support of Network and Product Strategies
- Responsible for developing, maintaining and improving program design documents related to provider, facility and ancillary payment methodology and pricing
- Serves as a resource to the Payment Operations Specialist I in functional/product areas
- Technical knowledge and familiarity with relevant payment security standards
- Demonstrated ability to proficiently utilize various types of office equipment such as telephone, personal computer, printer, photocopier, scanner, calculator, adding machine, fax machine, shredder
- Ability to analyze and compare data to ensure accuracy
- Ability to sit for long periods for certain job functions
- Minimum two (2) years payment specialist or benefits representative experience required
Payment Specialist Job Description
- Outstanding verbal, written and listening skills
- Educational background, diploma, or equivalent expertise or certification
- Any knowledge of additional language would be an advantage
- Resolve assigned accounts in a timely and accurate manner, which maximizes reimbursement in compliance with payer regulations and the department's policy and procedures
- Reviews historical payment information to determine accuracy of reimbursement
- Reviews potential payment variances and identifies true discrepancies
- Resolve payment disputes with payers by following appeal protocols and processes
- Take necessary AR adjustments in accordance with the department's adjustment policy
- Request relevant information from appropriate revenue cycle and clinical departments as required by payer
- Advises management of payment variance issues which may require attention in a timely manner
- In-depth working knowledge of Government, Commercial and Managed Care insurance carriers
- Good knowledge of payment technology and ecosystem
- 4+ years' experience in the e-commerce industry or digital payment provider
- E-commerce or payment service provider background is a must
- Capability to take decisions independently in a fast-paced and highly challenging working environment
- Knowledge of Physician Billing (Epic experience preferred)
Payment Specialist Job Description
- Managing SAP payment corrections and vendor credits
- Complete necessary daily reporting requirements
- Ensuring the company's compliance with record retention policies
- Perform the overall freight payment process
- Overseeing/monitoring all outbound EDI feeds between SAP and vendor
- Researching and recovering debit balances from vendor accounts
- Researching and reconciling past due invoices from vendors to ensure current account standings
- Creation of purchase requisitions to request new PO's
- Additional hours during heavy season may be required
- Walking through scenarios with customers, online banking, which will help educate our customers with alternative methods of making payments
- Proven track record with problem solving/issue resolution with professional, ancillary and facility types
- Experience working with payment methodologies and pricing
- Ability to work independently and integrate important information across cross functional departments to make assessments
- Assists to resolve complex billing discrepancies
- Month-end accruals, close tasks, and reconciliations
- Frequently required to coordinate efforts with other PCG departments (I.T., Legal, Compliance)
Payment Specialist Job Description
- Process and apply reimbursements from various sources such as CPP/QPP, WSIB, CSST
- Perform all Pay and Report activities for the in-country deadlines
- Take full ownership of issues and queries and ensure they are fully resolved in an efficient and effective manner, and according to agreed SLAs
- Ensure all control processes are executed effectively and evidences are created and saved
- Perform Balance Sheet Reconciliation on a monthly basis
- Perform Cash Managment activities ensure that bank reconciliation is appropriate and accurate
- Develop appropriate procedures to improve efficiency
- Being analytical, reactive and attentive to details
- The candidate would have proven analytical and problem solving skills, customer focus, and strong attention to detail
- Engages with retailers via multiple sources such as phone and e-mail to resolve retailer trade and non-trade related deduction errors and secures retailer repayment/collection commitments in a timely manner
- Strong Customer service skills and proven ability to meet and exceed Customer expectations
- Demonstrated PC skills, including proven knowledge of Windows and ability to operate standard office equipment
- 1+ year of healthcare underpayments and denials experience preferred
- Detailed knowledge of payer regulations, principles of accounting, reimbursement concepts and automated account receivable systems
- Knowledge of medical terminology, Current Procedural Terminology (CPT), and International Classification of Disease (ICD) preferred
- Ensures all underpayment and denial functions performed are compliant with applicable laws and regulations