Primary Functions 

1. Payment Processing & Posting 

· Post payments from insurance companies, government programs (Medicare/Medicaid), and 

patients into the RCM system. 

· Process Electronic Remittance Advices (ERA) and Manual Explanation of Benefits (EOB). 

· Apply necessary adjustments, refunds, and write-offs per payer guidelines. 

· Balance and reconcile daily deposits with posted payments. 

2. Denial Management & Reconciliation 

· Identify and post insurance denials while ensuring timely follow-up for resolution. 

· Work with the billing and accounts receivable teams to correct claim errors and resubmit 

claims. 

· Track underpayments and escalate discrepancies to the RCM Manager. 

3. Reporting & Documentation 

· Maintain accurate payment records and reconciliation reports. 

· Generate daily, weekly, and monthly reports on payment trends, denials, and discrepancies. 

· Ensure compliance with company policies and industry regulations (HIPAA, Medicare 

guidelines). 

4. Communication & Collaboration 

· Coordinate with the billing team, accounts receivable, and insurance companies to resolve 

Payment discrepancies. 

· Respond to inquiries from internal teams regarding posted payments. 

· Escalate unresolved payment issues to the appropriate leadership.