Pharmacy and Medical Payment Poster Specialist

Schedule & Location

Schedule: Monday through Friday, 8:00 AM – 5:00 PM, based on the assigned time zone (Eastern or Central Time).

Location: This position is expected to work on-site at one of our corporate office locations in Plantation, FL, or Remote

Job Description

The Pharmacy and Medical Payment Poster Specialist is responsible for the accurate and timely posting, processing, and reconciliation of medical and pharmacy insurance payments for accounts receivable (A/R). This role plays an important part in maintaining the accuracy and integrity of cash applications and A/R transactions while supporting efficient revenue cycle operations.

The specialist processes electronic and manual payments, including Electronic Remittance Advice (ERA), Electronic Funds Transfers (EFT), and lockbox payments. This position is also responsible for ensuring that all cash applications, adjustments, and related transactions are completed in accordance with established financial procedures, internal controls, and Finance Department policies.

Required Qualifications

• High school diploma or equivalent.
• Minimum of 3–5 years of medical and/or pharmacy insurance payment posting experience required.
• Direct experience posting payments for major medical and pharmacy claims is a must.
• Experience with ERA, EFT, lockbox, EOBs, denials, adjustments, refunds, write-offs, and payment reconciliation.
• Strong understanding of accounts receivable, revenue cycle, insurance billing, payment posting, and banking reconciliation.
• Knowledge of medical terminology.
• Working knowledge of ICD-10, HCPCS, and CPT coding.
• Ability to maintain strict confidentiality of patient information in accordance with HIPAA and applicable state and federal regulations.
• Strong verbal and written communication skills.
• Advanced computer skills, including proficiency with Microsoft Office, particularly Word and Excel.

Preferred Qualifications

• Certificate, associate degree, or bachelor's degree is a plus but not required.
• Experience with CPR+ Pharmacy Software, CareTend, and/or WeInfuse is preferred but not required.

Essential Functions and Responsibilities

• Process and apply daily cash receipts, non-cash transactions, A/R adjustments, denials, write-offs, and credit balance refunds.
• Perform electronic and manual payment and adjustment posting.
• Process ERA, EFT, lockbox, insurance, and patient payments.
• Prepare daily deposits, as applicable.
• Maintain daily deposit batch sheets.
• Prepare cash batches and establish the appropriate batches within the billing system.
• Process lockbox deposits with appropriate supporting documentation and patient identification.
• Reconcile posted checks against deposited checks.
• Review claim rejections and denials, evaluate EOBs, reconcile accounts, and make appropriate corrections.
• Post cash and credit card payments to patient accounts.
• Apply payments from EOBs, claims, and other documentation to the appropriate patient accounts.
• Enter appropriate contractual adjustments based on the Explanation of Benefits (EOB).
• Identify and flag payments with contractual adjustments above 10%, denials, and other unusual items for follow-up.
• Post denials and zero-pay claims.
• Process refunds in accordance with company policies and procedures.
• Process write-offs according to internal policies and procedures.
• Complete daily scanning of batches, as applicable.
• Process incoming correspondence appropriately.
• Compile and organize invoices, checks, EOBs, and related documentation.
• Communicate with pharmacy staff, field teams, patients, and other departments as needed.
• Perform other job-related duties as assigned.

Knowledge, Skills, and Abilities

• Strong knowledge of medical and pharmacy insurance payment posting and A/R processes.
• Ability to accurately interpret EOBs and ERAs and properly apply insurance payments, adjustments, denials, and contractual obligations.
• Strong reconciliation and problem-solving skills.
• Excellent attention to detail and a high level of accuracy.
• Ability to maintain accurate records and prepare reports and correspondence.
• Ability to prioritize and manage multiple responsibilities in a fast-paced environment.
• Ability to work independently with minimal supervision.
• Strong teamwork and collaboration skills.
• Commitment to excellent customer service.
• Ability to meet established deadlines.
• Ability to become and remain proficient in all systems and software required for the position.

Communication Skills

• Oral Communication: Communicates clearly and professionally, listens effectively, seeks clarification, when necessary, responds appropriately to questions, and participates effectively in meetings.
• Written Communication: Writes clearly and professionally, reviews work for spelling and grammar, communicates numerical information effectively, and can read and interpret written information.