Full-Time Payment Poster (eClinicalWorks / Out-of-Network) — Remote Adelfi Medical Billing Solutions Adelfi Medical Billing Solutions is a fully remote medical billing company serving 60+ healthcare practices across New York and New Jersey. We specialize in out-of-network billing, No Surprises Act (NSA) compliance, and Federal IDR arbitration. We're looking for an experienced, detail-driven Payment Poster to join our team full time.

What You'll Do

Post insurance and patient payments, adjustments, and denials accurately in eClinicalWorks (ECW), including manual EOBs, ERAs/835s, paper checks, virtual credit cards, and lockbox deposits. Post out-of-network payments and identify whether each claim falls under the NSA, a state surprise billing law (such as the NY Independent Dispute Resolution process), or standard OON terms. Capture and record the initial payment or denial date and amount on every OON claim, since this starts the 30-business-day open negotiation window. Identify and flag claims for open negotiation, and track deadlines so IDR can be initiated within 4 business days after negotiation ends. Recognize and document the Qualifying Payment Amount (QPA), remark codes, and NSA disclosures on payer EOBs. Identify payments processed through repricers and third-party networks (such as MultiPlan, Zelis, and Data iSight), and flag underpayments or unauthorized network discounts. Distinguish between payments sent to the provider and payments sent to the patient, and flag accounts for patient follow-up when needed. Correctly apply patient responsibility (deductible, coinsurance, copay) under NSA cost-sharing rules, and flag claims where balance billing isn't permitted. Post IDR determination payments and negotiated settlements, and reconcile them against the IDR log. Post single case agreement payments and verify them against agreed terms. Process recoupments, offsets, overpayments, and refund requests, and document takebacks against the original claim. Reconcile daily deposits to bank statements and payment batches, and resolve discrepancies quickly. Route denials and underpayments to the appropriate AR, appeals, or IDR team members with clear notes. Keep all posting within HIPAA and company compliance standards. Requirements 2+ years of medical payment posting experience, with demonstrated out-of-network posting experience. Hands-on experience in eClinicalWorks (ECW) is required. Strong working knowledge of the No Surprises Act, including QPA, open negotiation, and IDR timelines. Ability to read and interpret complex commercial EOBs, ERAs, CARC/RARC codes, and repricing statements. Understanding of commercial, Medicare, Medicaid, and self-funded/ERISA plans. Experience reconciling deposits and identifying posting errors or variances. Excellent accuracy, organization, and deadline management. Comfortable working independently in a fully remote environment with a reliable internet connection and a private workspace. Preferred Familiarity with the Federal IDR portal or NY state IDR. Experience with surgical, orthopedic, or specialty practice billing. Coding or billing certification (CPC, CPB, or similar). Proficiency in Excel. About Adelfi Medical Billing Solutions At Adelfi Medical Billing Solutions, we provide exceptional medical billing and revenue cycle management services to healthcare providers of all specialties. Our team of experienced professionals has the knowledge and expertise necessary to navigate the complexities of the healthcare billing industry, and we are committed to delivering accurate and timely payment for the services our clients provide. We believe in taking a proactive approach to medical billing, leveraging advanced technology and tools to optimize billing processes, reduce errors and denials. and identify opportunities for cost savings. At Adelfi Medical Billing Solutions, we understand that medical billing is not just about processing claims and collecting payments; it's about providing a high level of service that supports the goals and objectives of our clients.