Coral Connect

General

• Post insurance payments, patient payments, EFTs, checks, lockbox payments, and credit card transactions accurately and timely.
• Review EOBs, ERAs, and payer remittance files.
• Enter contractual adjustments, write-offs, coinsurance, deductibles, copays, and patient responsibility amounts.
• Process ERA files and resolve posting exceptions and discrepancies.
• Identify denials, underpayments, overpayments, recoupments, and payment discrepancies.
• Assign accounts to appropriate work queues and flag reimbursement trends and payer issues.
• Reconcile daily deposits, payment batches, bank deposits, and remittance totals.
• Research and resolve unapplied or unidentified payments.
• Identify credit balances and overpayments and assist with refund processing.
• Post specialty pharmacy claim payments and adjustments and reconcile pharmacy payments.
• Post and review payments for home infusion nursing, drug, supply, and administration services.
• Maintain posting accuracy, conduct self-audits, follow client-specific guidelines, and document posting activities.
• Collaborate with billing, accounts receivable, denial management, client, and RCM teams.
• Support client inquiries, special projects, and reporting requests.
• Maintain HIPAA and regulatory compliance and protect patient and client confidentiality.

Cash Posting Specialist

Director

• Drive development and deployment of standardized billing and reimbursement playbooks across all clients
• Partner with the technology team to define billing enablement requirements, including denial tracking, reimbursement analytics, and claims workflow visibility
• Provide strategic direction for billing and reimbursement operations across multiple client organizations
• Serve as the infusion billing and reimbursement subject matter expert for the RCM organization
• Develop standardized best practices for infusion billing, coding, and revenue cycle processes
• Mentor high-potential associates and billing staff
• Advise clients on billing and reimbursement matters and serve as the main escalation point
• Assist with monthly business reviews covering financial performance, reimbursement trends, and optimization roadmaps
• Recommend payor contracting, drug acquisition/reimbursement, and program financial efficiency improvements
• Research client performance, analyze trends, and recommend improvements
• Align drug acquisition strategy with reimbursement and GPO performance
• Evaluate billing readiness and downstream claims workflows to identify reimbursement risk
• Improve reimbursement for infusion medications, administration services, and related supplies
• Support payor-specific billing and documentation strategies
• Provide expertise on medical versus pharmacy benefit billing pathways
• Partner with intake and RCM leadership to convert verified referrals into accurate claims
• Guide infusion billing involving HCPCS/J-codes, NDCs, infusion administration CPT codes, drug wastage, and modifiers
• Resolve complex payor reimbursement issues and establish escalation frameworks for billing and denial trends
• Monitor revenue cycle metrics including drug reimbursement, denials, days in A/R, and revenue per infusion visit
• Develop data-driven operational improvement plans and performance monitoring tools
• Ensure compliance with payor requirements, CMS guidelines, OIG guidance, and industry best practices
• Support audit readiness for billing and claims documentation
• Develop training materials, competency frameworks, and operational protocols
• Identify billing and claims inefficiencies and implement standardized, scalable solutions through automation, technology adoption, and workflow redesign

Cash Posting Specialist

Director of Billing