Payment Posting & Denial Identification Specialist

We are seeking an experienced Payment Posting & Denial Identification Specialist to support back-end revenue cycle operations for a high-volume medical practice. This role is responsible for accurate insurance payment posting, EOB/ERA review, denial identification, adjustment review, and initial claim issue classification.

The ideal candidate should have strong experience reviewing remittance details, identifying payment discrepancies, classifying denials, and ensuring claims are not incorrectly adjusted, written off, or closed without proper review.

Key Responsibilities:

• Accurately post insurance payments from EOBs and ERAs.
• Review remittance details for denials, partial payments, underpayments, recoupments, offsets, contractual adjustments, and patient responsibility.
• Interpret CARC/RARC codes, payer denial messages, adjustment codes, and claim-level payment details.
• Identify denied, rejected, underpaid, or incorrectly processed claims during payment posting.
• Ensure contractual adjustments, write-offs, and patient responsibility amounts are posted appropriately.
• Flag claims that require AR follow-up, corrected claim submission, appeal, reconsideration, or management review.
• Identify posting errors, incorrect adjustments, duplicate postings, and improper write-offs.
• Classify denial reasons by category, including eligibility, coordination of benefits, authorization, medical necessity, coding/modifier, credentialing, timely filing, documentation request, and payer processing issue.
• Maintain accurate claim notes and denial/payment posting logs.
• Prepare daily work reports summarizing payments posted, denials identified, unresolved issues, and claims requiring escalation.
• Coordinate with AR follow-up and appeals teams to ensure claims move to the correct next step.
• Support process improvement by identifying recurring denial and payment posting trends.

Qualifications & Experience:

Required

• Prior experience in medical billing payment posting, denial identification, or revenue cycle operations.
• Strong understanding of EOBs, ERAs, CARC/RARC codes, payer adjustments, denials, and patient responsibility.
• Ability to identify when a claim should not be written off or closed without further review.
• Experience using payer portals, clearinghouses, billing software, and spreadsheet trackers.
• Strong attention to detail and ability to work accurately with high-volume payment data.
• Good documentation, communication, and organizational skills.
• Ability to work independently and meet daily productivity expectations.

Preferred

• Experience in orthopedics, physical therapy, radiology, surgery, DME, Medicare, commercial insurance, or out-of-network billing.
• Familiarity with systems such as ModMed / EMA, TriZetto, Availity, Office Ally, Medicare portals, UHC, BCBS, Cigna, Aetna, and other payer portals.
• Experience identifying credentialing/enrollment-related denials, authorization issues, modifier-related denials, and underpayment trends.
• Experience working in a high-volume medical practice or RCM environment.

Ideal Candidate:

The ideal candidate is detail-oriented, accurate, and able to identify claim issues during the payment posting process. This person should understand that payment posting is not only data entry, but also a critical control point for identifying denials, underpayments, incorrect adjustments, and claims that require further action.

To Apply:

Please submit your resume with relevant experience in payment posting, EOB/ERA review, denial identification, and medical billing systems.

EEO Disclosure:

iOrtho is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.