Job Description

We are seeking a highly detail-oriented Payment Application Specialist to join a leading pediatric healthcare organization in San Diego. In this role, you will be responsible for researching, auditing, reconciling, and applying all cash receipts to Accounts Receivable (AR) accounts.

The ideal candidate is a subject matter expert (SME) in payment application who can accurately interpret Explanations of Benefits (EOBs), manage recoupments, and handle provider-level adjustments (PLBs). You will play a critical role in ensuring financial accuracy by identifying non-patient payments, processing denials with precision, and resolving complex balancing issues.

Location: San Diego, CA (92111) – Onsite

Employment Type: Full-Time

Status: Possible Temp-to-Hire

Schedule: Monday – Friday, 8:00 AM – 5:00 PM

Key Responsibilities

• Payment Posting: Research, audit, and apply payments and denials using correct remittance codes to the appropriate liability buckets.
• Reconciliation: Conduct in-depth research to resolve balancing issues and reconcile unidentified payments posted to clearing accounts.
• Complex Adjustments: Interpret EOBs to apply payments, recoupments, and provider-level adjustments (PLBs).
• System Management: Use internal balancing tools and system-generated reports to reconcile variances; identify and escalate issues with ERAs or contractual calculations.
• Workflow Optimization: Identify areas for process improvement, document workflows, and participate in testing for new projects.
• Mentorship: Act as a SME to train team members and improve the overall knowledge base of the department.
• Administrative: Handle Non-Sufficient Funds (NSF) payments and transfer non-patient payments to the correct general ledger accounts using designated codes.

Qualifications & Requirements

• Experience: * Minimum of 2 years of professional experience in payment posting (5+ years preferred).
• Brightree (BT) experience is highly preferred. Candidates with relatable Homecare payment posting experience will be considered.
• Proven experience working with Commercial Payors .
• Education: * High School Diploma or equivalent is required.
• Note: Candidates must be able to provide a copy of their diploma or official transcripts during the onboarding process.
• Technical Skills: * Proficiency in interpreting complex EOBs and handling ERA variances.
• Strong understanding of AR accounts and general ledger transfers.
• Ability to use system-generated reports for deep-dive reconciliation.

Work Environment

This is an onsite position located at our Copley Drive office in San Diego. We offer a stable, professional environment dedicated to supporting healthcare excellence.

We are an equal opportunity employer. All candidates must pass a background check and provide educational verification.

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