Position Summary: 

The Payments Specialist is responsible for accurately posting, reconciling, and managing insurance payments for behavioral health providers. This role ensures that all revenue received from insurance as a direct result of Compass' billing efforts is accurately recorded and tracked. The Payments Specialist plays a key role in supporting the financial health of both Compass and its clients by maintaining clean payment data, identifying underpayments or missed revenue opportunities, and collaborating with third-party vendors to optimize reimbursement outcomes. 

Essential Duties and Responsibilities: 

•  Accurately post and reconcile insurance payments and electronic remittances (ERAs) 
•  Review and interpret Explanation of Benefits (EOBs) to ensure correct allocation of payments and adjustments. 
•  Identify and escalate denied claims, underpayments, and payment discrepancies. 
•  Coordinate with third-party vendors to mitigate cost-containment impacts and support repricing workflows. 
•  Enter claim data into Compass’ workflow-management platform to support repricing and payment negotiation processes. 
•  Monitor for opportunities to recover additional revenue through rate negotiations and appeals. 
•  Maintain compliance with payer policies, HIPAA regulations, and internal documentation standards. 
•  Deliver accurate and timely reporting to internal stakeholders to support decision-making and operational alignment. 
•  Perform other duties as assigned by the Payments Supervisor or RCM Director. 
•  Qualifications: 
•  1–3 years of experience in medical billing, payment posting, or healthcare revenue cycle management (behavioral health  preferred). 
•  Familiarity with insurance reimbursement, claim processing, and third-party repricing vendors. 
•  Strong attention to detail, organization, and data accuracy. 
•  Proficiency with EHR systems, billing platforms, and Microsoft Office tools. 
•  Effective written and verbal communication skills. 
•  Strong critical thinking and problem-solving ability. 
• Key Metrics: 
•  Payment Accuracy - Maintain accurate posting and reconciliation of payments with minimal errors or missed revenue. 
•  Discrepancy Resolution - Identify and escalate underpayments, denials, and issues with third-party vendors in a timely manner. 
•  Workflow Compliance - Enter claim and payment data into designated systems accurately and in accordance with department workflows. 
• Reporting & Collaboration - Provide timely, reliable updates and data to internal teams and stakeholders. 
•  Vendor & Repricing Support - Assist in repricing and cost containment efforts by ensuring accurate and complete data entry