Payment Application Specialist

SUMMARY:

This job is primarily responsible for payment application related to accounts receivable. This position requires working in several billing, receivable and ancillary systems that require manual intervention due to complexity of systems and products underwritten by the Enterprise. Responsible for providing accurate and timely payment application and balancing, along with other ad hoc requests. Contacts include various employees of the Enterprise, agents, policyholders, medical facilities, other insurance companies, NCCI and legal representatives.

PRIMARY RESPONSIBILITIES:

· Balances, validates, and posts incoming cash receipts and other receivable-based transactions to various billing and ancillary systems for the Enterprise.

· Independently troubleshoots and researches issues related to cash receipts and accounts receivable; reaches out to other departments regarding issues as needed.

· Initiates premium write-off requests for the Enterprise as applicable after appropriate balancing and analysis has been completed.

· Researches and monitors suspended cash for the Enterprise. Follow-up with policyholders, agencies, and other institutions to ensure timely and accurate posting of cash receipts. Processes refunds as deemed necessary after appropriate balancing and analysis has taken place.

· Processes and/or requests money moves to ensure accurate posting of cash.

· Researches and identifies all Non-Sufficient Funds transactions and returned ACH payments for the Enterprise in a timely manner. Applies applicable fees as deemed necessary.

· Collaborates with other departments regarding billing transactions and reconciliation questions.

· Monitors, tracks and processes transactions related to collateral on hand to ensure policies are adequately funded.

· Responds to internal and external customer requests via telephone, written or electronic correspondence. Ad hoc correspondence is drafted to address complaints or requests for information, including but not limited to, regulatory inquiries related to claim recoveries, reconciliation of premium payments, uncollectible balances, and commission receivables and payables.

· Completes inquiries for internal and external audit requests.

· Participates in ad-hoc projects as assigned by management.

EMPLOYMENT QUALIFICATIONS:

A. EDUCATION REQUIRED:

High school diploma or G.E.D. .

· Processes payments made over the phone by external customers.

· Maintains confidentiality of information processed.

· Maintains an in-depth knowledge of Enterprise processes and systems related, but not limited to billing, policy processing, claims, dividends, and commissions.

· This position requires working in various billing, receivable and ancillary systems that require substantial manual efforts due to system limitations or complexity of products underwritten by the Enterprise.

B. EXPERIENCE REQUIRED: 

Minimum of two (2) years’ experience in billing, accounts receivable, general ledgers and financial reporting systems or equivalent work which provides the necessary skills, knowledge, and abilities.

C. SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

· Basic knowledge in bookkeeping, billing, and accounts receivable

· Basic knowledge of financial reporting, including journal entries, general ledger accounts and cost center structures.

· Ability to analyze details of policy billing, claims and payment data and, based on this analysis, make efficient and effective independent decisions within authority.

· Ability to proofread documents for accuracy of spelling, grammar, punctuation, and format.

· Basic Knowledge of insurance operations. Specifically, as they pertain to state specific requirements.

· Excellent math skills

· Ability to accurately interpret and analyze data.

· Ability to process transactions on multiple processing systems.

· Ability to use diplomacy, discretion and appropriate judgment when addressing internal and external customers.

· Ability to manage multiple priorities and meet established deadlines.

· Ability to proofread documents for accuracy of calculations.

· Excellent organizational skills and ability to prioritize work in order to meet strict deadlines.

· Excellent oral and written communication skills.

· Excellent analytical and problem-solving skills.

· Knowledge of computers and ability to enter alpha/numeric data accurately.

· Knowledge of word processing software.

· Basic knowledge of database software.

· Advanced knowledge of spreadsheet software.

· Ability to effectively exchange information clearly and concisely, reports facts and other information and respond to questions as appropriate.

· Knowledge of billing, policy and claim processing systems.

D. ADDITIONAL EDUCATION, EXPERIENCE, SKILLS, KNOWLEDGE AND/OR ABILITIES PREFERRED:

· Bachelor’s degree in Accounting, Finance or Business.

· Knowledge of departmental procedures, workflows, and systems.

· Insurance education coursework.

· Knowledge and experience of policy processing, claim and financial reporting systems.

WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards.

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