Payment Posting Executive (RCM)

The Payment Posting Executive is responsible for reviewing and validating automated payment postings to ensure accurate reimbursement and account reconciliation. At TrueRCM, approximately 85% of payment posting is automated through our proprietary platform, allowing the team to focus on payment exceptions, reconciliation, recoupments, offsets, overpayments, balancing, and payer-specific payment analysis.

The ideal candidate should possess strong knowledge of Explanation of Benefits (EOBs), Electronic Remittance Advice (ERA), payer reimbursement methodologies, and payment reconciliation.

Key Responsibilities

Payment Posting & Validation

• Review and validate automated payment postings for accuracy.
• Post manual payments that cannot be processed through automation.
• Verify payments against EOBs, ERAs, and payer remittance advice.
• Ensure payments are accurately applied to the appropriate patient accounts and billing codes (CPT/HCPCS).

Payment Reconciliation

• Balance daily payment batches with bank deposits and remittance reports.
• Reconcile bulk check payments and virtual credit card (VCC) payments.
• Identify and resolve payment discrepancies before final posting.
• Ensure all payment batches are balanced and closed accurately.

Payment Exception Management

• Identify and process recoupments initiated by insurance payers.
• Review and reconcile payer offsets across multiple claims.
• Identify overpayments and initiate appropriate refund or adjustment workflows.
• Process underpayments and escalate accounts requiring AR follow-up.
• Review zero-pay and partial-pay claims to determine the appropriate next steps.

Insurance Payment Knowledge

• Understand payer reimbursement methodologies for:

• Medicare
• Medicaid
• Medicaid Managed Care (MCO)
• Medicare Advantage
• Commercial Insurance
  • Interpret payer-specific EOB and ERA remarks and adjustment codes.
  • Review contractual adjustments based on payer agreements.

Quality & Compliance

• Ensure compliance with HIPAA and company policies.
• Maintain high posting accuracy and productivity.
• Document payment exceptions and resolutions appropriately.
• Collaborate with AR, Billing, and Client Services teams to resolve payment-related issues.

Required Skills

• Good understanding of the US Healthcare Revenue Cycle.
• Knowledge of:

• EOBs and ERAs
• CPT/HCPCS billing codes
• Payment posting workflows
• Recoupments
• Payer offsets
• Overpayments and refund processing
• Contractual adjustments
• Payment balancing and reconciliation
  • Ability to interpret insurance payment details and remittance advice.
  • Strong analytical and problem-solving skills.
  • Excellent attention to detail.
  • Good communication and documentation skills.

Preferred Qualifications

• Graduate in any discipline.
• 1–3 years of experience in US Healthcare RCM.
• Experience in Payment Posting, Cash Posting, Medical Billing, or Revenue Cycle Operations.
• Experience with Practice Management Systems, ERA processing, EOB posting, ClaimMD, Waystar, or similar healthcare payment platforms is preferred.

Key Performance Indicators (KPIs)

• Payment posting accuracy.
• Payment batch balancing accuracy.
• Reconciliation completion within SLA.
• Exception resolution turnaround time.
• Quality audit score.
• Productivity (payments/transactions processed per day).
• Overpayment and recoupment resolution accuracy.
• Daily balancing compliance.

TrueRCM leverages advanced automation to process approximately 85% of payment posting activities, enabling our Payment Posting team to focus on high-value financial reconciliation and payment analysis. Team members gain expertise in payer reimbursement, remittance interpretation, exception management, and revenue cycle optimization, providing excellent opportunities for career growth within US Healthcare Revenue Cycle Management.