Accounts Receivable/Payable Manager Onshore Operations

$76,800 - $105,800/Yr

Humana - Boston, MA

Full-time - Mid Level

Remote - Boston, MA

Insurance Carriers and Related Activities

About the position

The Revenue Cycle Manager (Onshore Operations) is responsible for overseeing the onshore team that manages revenue cycle processes, including credit balance validation, customer service escalations, payment reconciliation, and auditing. This role involves supervising the Payment Reconciliation Professional and Payment Posting Auditors to ensure accurate financial operations and compliance with organizational standards. The manager will also focus on process improvements and reporting to enhance operational efficiency.

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.

Benefits

• Health benefits effective day 1
• Paid time off, holidays, volunteer time and jury duty pay
• Recognition pay
• 401(k) retirement savings plan with employer match
• Tuition assistance
• Scholarships for eligible dependents
• Parental and caregiver leave
• Employee charity matching program
• Network Resource Groups (NRGs)
• Career development opportunities