Manager Posting and Credits

Job Duties:

• Oversee timely, accurate application of insurance and patient payments received through ERA, EFT, ACH, lockbox, credit card, check, and other channels, including monitoring of posting workflows, interfaces, and electronic remittances.
• Co-own reconciliation of posted payments to bank deposits, remittance data, and general ledger activity in partnership with Finance and Accounting.
• Ensure compliance with HIPAA, payer requirements, governmental regulations, audit standards, and established financial controls, with emphasis on patient refund and credit balance handling, Medicare credit balance and overpayment requirements, and state unclaimed property obligations.
• Lead efforts to identify and resolve patient and payer credit balances, overpayments, duplicate payments, and misapplied transactions, and manage the related refund processes in compliance with contractual, regulatory, and organizational requirements.
• Ensure timely investigation and resolution of unapplied cash, misapplied payments, posting errors, payment variances, and missing remittance activity.
• Ensure payments and adjustments are posted accurately to the correct billing component (global, professional, or technical) and resolve related variances and credit balances.
• Establish and monitor key performance indicators (KPIs) for productivity, service levels, and quality, and oversee posting quality assurance and control programs covering payments, adjustments, refunds, and credit balances.
• Develop departmental strategies, workflows, policies, and performance standards to ensure efficient, accurate, and compliant operations.
• Develop and maintain reporting on posting performance, auto-posting rates, unapplied cash, credit balances, refund activity, and financial variances, and analyze trends, posting exceptions, and quality findings to identify risks and recommend corrective actions.
• Lead departmental process improvement and automation initiatives focused on ERA/EFT posting, auto-posting rates, accuracy, scalability, cash visibility, and control enhancement.
• Collaborate with internal and external stakeholders, including Accounts Receivable, Billing, Denials, Finance, and Accounting leaders, payer representatives, banking partners, vendors, Information Technology, and offshore teams, to resolve complex payment, credit balance, and cash application issues.
• Support organizational initiatives, system implementations, integrations, and revenue cycle transformation projects, including onboarding of acquired sites.

Leadership Responsibilities:

• Lead, mentor, and develop team members to achieve performance goals.
• Deliver timely, constructive feedback, recognizing achievements and addressing performance issues.
• Assess staffing requirements and partner with HR to recruit, hire, and seamlessly onboard new employees.
• Cultivate a collaborative, patient-focused on timely resolution of patient credit balances, engagement, and retention.
• Make well-justified decisions aligned with organizational policies, including approval of refunds, adjustments, and write-offs within delegated authority limits set by Finance and Compliance.
• Maintain segregation of duties across payment posting, refund preparation, and refund approval.
• Direct operational, budgetary, and financial activities within area of responsibility, including offshore vendor headcount and cost.
• Manage offshore and vendor partner performance, including service levels, quality audits, and training, while driving automation to reduce manual effort and vendor FTEs over time.

Education and Experience:

• High School Diploma or equivalent required; Bachelor's degree in Finance, Accounting, Business Administration, Healthcare Administration, or related field preferred.
• Minimum ten (10) years of healthcare revenue cycle experience required.
• Minimum three (3) years of progressive leadership experience managing revenue cycle operations required.
• Experience managing payment posting, cash application, credit balance, and refund operations required.
• Experience within high-volume healthcare settings, such as physician practice or outpatient clinics, preferred.
• Experience managing offshore teams, vendors, or multi-site operations, and leading automation or productivity initiatives in posting operations, preferred.

Knowledge, Skills, and Abilities:

• Advanced knowledge of healthcare payment posting, cash application, and revenue cycle operations, including ERA/EFT processing, EOB interpretation, lockbox operations, contractual adjustments, and electronic remittances.
• Strong understanding of Medicare, Medicaid, commercial and managed care reimbursement, and payer contracts.
• Knowledge of credit balance, overpayment, and refund requirements, including payer recoupment processes and state unclaimed property regulations.
• Ability to analyze complex financial and operational data and translate findings into actionable recommendations.
• Knowledge of auditing, risk assessment, compliance, and quality management principles.
• Strong leadership, strategic planning, vendor management, and organizational development skills.
• Ability to manage onshore and offshore teams, priorities, and projects in a fast-paced environment.
• Strong communication, presentation, and relationship management skills, including cross-department partnerships.
• Advanced proficiency in Microsoft Excel and healthcare billing, practice management, and reporting systems, and familiarity with posting automation and workflow tools.

Originally posted on Himalayas