Accounts Receivable/Payable Manager Onshore Operations

Humana - Trenton, NJ

Full-time - Mid Level

Hybrid - Trenton, NJ

Insurance Carriers and Related Activities

About the position

The Accounts Receivable/Payable Manager for Onshore Operations at Conviva is responsible for overseeing the onshore team that manages revenue cycle processes. This includes credit balance validation, customer service escalations, payment reconciliation, and auditing. The role involves leading a team of professionals to ensure accurate financial operations, compliance with standards, and process improvements.

Responsibilities

• Lead and manage the onshore team responsible for credit balance validation, customer service escalations, and adjustments.
• Oversee the Payment Reconciliation Professional who reconciles payment posting with the bank and manages all EDI/ERA/EFT setup and troubleshooting.
• Supervise the Payment Posting Auditors who audit offshore payment posting work to ensure accuracy and compliance with internal controls.
• Ensure that payment posting reconciliations between the general ledger, payment posting systems, and bank accounts are completed accurately and in a timely manner.
• Oversee the setup and management of EDI, ERA, and EFT configurations to ensure smooth payment posting operations.
• Coordinate with finance to resolve any discrepancies in payment reconciliation.
• Oversee the auditing of the offshore payment posting team's work, ensuring accuracy in all payment postings.
• Conduct reviews of refunds, adjustments, credit balances, and variances to ensure compliance with financial policies.
• Supervise 'auditing the auditor' activities to ensure the integrity of internal and external audit processes.
• Supervise the accurate processing of credit balances, including insurance and patient refunds, ensuring timely and compliant resolution.
• Manage the team responsible for patient and insurance refunds and ensure alignment with regulatory standards.
• Ensure that customer service escalations related to billing or AR issues are addressed and resolved within established timelines.
• Manage the team's efforts in reviewing variances and making necessary contractual or administrative adjustments.
• Oversee the proper handling of inactive or deceased patients' accounts and claims without insurance.
• Identify and implement improvements in the payment reconciliation and posting process.
• Provide regular reporting on the team's KPIs and ensure alignment with organizational goals.

Requirements

• Bachelor's Degree
• 6 or more years of revenue cycle experience
• 2 or more years of management experience
• Experience completing revenue cycle reporting and analysis

Nice-to-haves

• Certified Revenue Cycle Representative Certificate
• Experience leading a team of revenue cycle professionals