Provide overall leadership and support to Centralized Payment Posting supervisors and staff, including proactive guidance, troubleshooting support, issue escalation, and project prioritization
Identify and resolve problems in the payment posting processes impacting downstream reconciliation activities and when appropriate, identifies and initiates change to prevent future problems or improve existing processes
Oversee the handling of escalated complaints or inquiries regarding Centralized Payment Posting functions to help ensure correct and satisfactory resolution
Manage department in compliance with established policies and procedures of AdventHealth and helps ensure that all policies and procedures reflect compliance with government regulations
Develop and maintain an understanding of Federal, State, local and industry regulations, rules, and standards to help ensure compliance with payment posting and refund requirements (CMS, Federal and State legislation, etc.)
Develop, implement, and monitor key performance indicators and productivity goals; identify root cause for variances and applicable process improvements; and report key findings to appropriate leadership
Responsible for the establishment and effectiveness of internal controls
Review and approve refunds, write-offs and adjustments on accounts, as defined in AdventHealth policies
Work collaboratively with other department leadership, including revenue cycle, finance, IT, and physician practice personnel
Utilize knowledge of revenue cycle processes that include insurance claim follow-up, denial management, payment posting, credit resolution, etc.
Utilize knowledge of contractual constraints potentially impacting payer responsibility of adjudication
Achieve superior customer satisfaction by embracing and exemplifying the AdventHealth service standards
Responsible for other duties as assigned by the AdventHealth leadership team
What You Will Need:
Bachelor’s degree in Healthcare Administration, Finance, Business Administration, or equivalent degree from a four-year accredited university or college or an Associate degree plus 3 years of relevant experience
Minimum four years of experience in healthcare revenue cycle or payment posting operations
Minimum two years of experience working as a manager, supervisor or lead with direct reports
The Centralized Payment Posting team is responsible for payment posting activities for the majority of AdventHealth services provided. Under minimal supervision of the Director of the Payment Reconciliation Center, the Payment Manager coordinates and manages the cash control functions, including but not limited to posting insurance and patient payments, managing patient refunds and credit balances, patient and insurance correspondence, reconciliation, and other miscellaneous functions. The Manager provides direction and support to staff, promotes staff development, and collaborates with other managers, directors, and administrative staff to help ensure operations function in a safe, effective, and fiscally responsible manner. The Manager creates a clear vision for the future and defines the values that underlie the day to day activities of assigned functions. Additional responsibilities include analysis and resolution of problems related to their areas of assignment as well as personnel activities including hiring, training, development, and termination of assigned supervisors / staff. The Manager is also responsible to maintain a working knowledge of core functions throughout the Reconciliation Services department.
The Manager works closely with other Reconciliation Services teams to help ensure efficient and timely processes and provides detailed feedback to the Director regarding team performance. This position is responsible for monitoring payment and adjustment trends, specifically significant changes and/or any anomalies. This position monitors and interprets reports and dashboards, including payment reports, monthly A/R, reconciliation reports and all other reports and dashboards as necessary. The Manager helps ensure the timeliness and appropriateness of posting payments. The Manager works closely with AdventHealth Information Technology (AIT) resources, clearinghouses, insurance payers, and bank vendors to help ensure the highest level of technology and automation is being utilized throughout the payment posting functions.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.