Medical Claims Payment Posting, Reconciliation Specialist
External
Abby-care · WorldwidePrepare for this interview
EliteAI-generated questions, company research, and talking points tailored to this role
About the role
The Medical Claims Payment Posting, Reconciliation & Reporting Specialist is responsible for accurately posting insurance payments, reconciling daily deposits, resolving payment discrepancies, and generating financial and operational reports. This role ensures the integrity of revenue cycle processes and supports the organization's financial performance through precise payment management and analysis.
Responsibilities
- Payment Posting
- Accurately post insurance claim payments, adjustments, and denials into the practice management or billing system.
- Review and interpret Explanation of Benefits (EOBs), Electronic Remittance Advices (ERAs), and correspondence from payers.
- Apply correct contractual adjustments and identify underpayments, overpayments, or missing payments.
- Process payment batches and reconcile payment uploads to bank deposits.
- Reconciliation
- Perform daily reconciliation of posted payments against bank statements and deposits.
- Investigate discrepancies between posted amounts and actual payments; escalate unresolved variances as needed.
- Maintain accurate logs of deposits, remittances, and reconciliation summaries.
- Conduct monthly reconciliation for internal financial reporting requirements.
- Denial and Issue Resolution
- Identify claim denials, partial payments, or payer inconsistencies.
- Communicate with billing team members or payers to resolve payment issues.
- Track recurring denial trends and recommend corrective actions to improve clean-claim rates.
- Reporting
- Produce daily, weekly, and monthly payment and reconciliation reports.
- Generate operational reports such as payment trends, payer performance, denial summaries, and accounts receivable insights.
- Provide analysis supporting month-end closing and financial reviews.
- Assist leadership with customized reporting requests.
- Compliance & Documentation
- Ensure compliance with HIPAA, payer guidelines, and internal financial protocols.
- Maintain accurate and organized documentation of payments, remittances, and reconciliation records.
- Support audit requests by supplying detailed payment and reporting documentation.
Requirements
- High school diploma or equivalent; associate degree or business/healthcare coursework preferred.
- 3-5 years of experience in medical billing, payment posting, or healthcare revenue cycle operations.
- Strong knowledge of ERAs, EOBs, CPT/ICD-10 codes, and insurance payer processes.
- Proficiency with billing systems (e.g., Epic, Athena, NextGen, eClinicalWorks, Kareo, etc.) and Excel/Google Sheets.
- Excellent attention to detail, analytical skills, and ability to work independently with high accuracy.
- Strong communication and problem-solving skills.
- Core Competencies
- Accuracy & attention to detail
- Revenue cycle understanding
- Analytical thinking
- Time management & multitasking
- Financial reconciliation
- Data reporting & interpretation
- Confidentiality & compliance awareness
Benefits
Additional Information
About Abby Care: Powering the future of care at home for all of America. Abby Care is building the leading AI-native platform for family-led care. America is facing a growing care crisis. Millions more people need care at home than ever. Over 50 million family caregivers support loved ones without the tools, training, or recognition they deserve. We believe families are the largest untapped caregiving workforce in America, and that technology can help them deliver better care while driving stronger outcomes and greater transparency across the healthcare system. Abby Care combines clinical oversight with an AI-powered platform to train, enable, and support family caregivers in delivering high-quality care at home. Our platform helps health plans and government partners better understand, verify, and improve care in the home. We expand access to care, reduce reliance on higher-cost settings, and help ensure public dollars are spent effectively. We are proud to partner with leading health plans, providers, and community organizations and are backed by top VCs. We envision a future where family-led care is a core part of the healthcare system. Abby Care is building that future. Join us in solving one of the most important challenges of our time.
Your Match
How well this role fits your profile.
Company Intel
What employees say
Worked at abby-care? Share your experience