Payment Posting and Cash Application Representative (Administrative)

Title: Payment Posting and Cash Application Representative
Reports to: Director, Patient Financial Services
Classification: Individual Contributor
Location: Boston (Hybrid)
Job description revision number and date: V2.0; 4.23.25

OrganizationSummary:
Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 52 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices in Massachusetts and across the country. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.

Job Summary:
We are seeking an experienced Payment Posting Cash Application Representative with expertise in FQHCs, proficiency in Epic systems, and familiarity with Massachusetts healthcare payment processing. The ideal candidate will have firsthand experience with 835 and 837 files, working with insurance companies, and collaborating with banks to ensure accurate payment posting and reconciliation. This role is critical in maintaining the integrity of cash control processes and supporting the revenue cycle team.

Responsibilities:
Accurately post payments, adjustments, and denials from electronic remittance advice (ERA) files and manual remittances into Epic and other billing systems
Reconcile daily payment batches to ensure all funds are accounted for and discrepancies are resolved promptly
Monitor unapplied payments and resolve posting errors in a timely manner
Download, review, and process ERA files from payer portals and clearinghouses
Identify and resolve issues related to 835 remittance files, such as missing or incomplete data
Collaborate closely with payers and clearinghouses to address ERA-related discrepancies
Ensure accuracy and completeness of 837 claim submissions and 835 remittance files
Collaborate with IT and billing teams to troubleshoot file transmission issues and ensure compliance with electronic data interchange (EDI) standards
Review and validate payment and adjustment details within 835 files for accuracy
Reconcile payments received with bank deposits, payer remittances, and system records
Maintain accurate records of payment posting activities, ensuring compliance with organizational policies and audit requirements
Assist in month-end close processes, including cash reconciliation and reporting
Liaise with insurance companies to resolve payment discrepancies, missing remittances, and denied claims
Work with banking institutions to ensure accurate deposit processing and address returned or rejected transactions

Function as a point of contact for inquiries related to payment posting and ERA processes
Generate and analyze payment posting and cash reconciliation reports to identify trends and areas for improvement
Provide feedback to leadership on payer performance, denial trends, and process inefficiencies
Assist in preparing data for internal and external audits
Ensure compliance with FQHC-specific guidelines, payer requirements, and Massachusetts healthcare regulations
Stay updated on changes to billing codes, remittance formats, and EDI standards
Develop and implement best practices for payment posting and cash control processes
Other duties as assigned

Required Skills:
Knowledgeable of Massachusetts healthcare billing regulations and payer requirements
Proficiency in Epic systems, with experience in payment posting and remittance workflows
Strong understanding of 837 claim files, 835 remittance files, and EDI processes
Familiarity with Massachusetts healthcare billing regulations and payer requirements
Experience working with insurance companies, banks, and clearinghouses is a plus
Excellent diligence, problem-solving skills, and ability to meet deadlines
Solid communication skills across stakeholders, diligence, and problem-solving skills
Experience in Microsoft Office Suite
Must have a strong commitment to quality assurance and exceptional customer service
A strong commitment to C3s mission

Desired Other Skills:
Epic experience preferred
Familiarity with the MassHealth ACO program
Familiarity working in Federally Qualified Health Centers (FQHC)
Experience with anti-racism activities, and/or lived experience with racism is highly preferred

Qualifications:
High school diploma or equivalent required; Associates or Bachelors degree in business, accounting, or healthcare administration is preferred
Minimum of 3 years of payment posting or cash control experience, preferably in an FQHC setting

** In compliance with Covid-19 Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law. **