Lead Medical Payment Processor

Title - Lead Medical Payment Processor

Location - Los Angeles, CA, US (This role is 100% on-site reporting to HQ)

Start : Oct 30, 2023 | Duration : 26 Weeks

Job Summary :

The Lead Medical Payment Processing is responsible for the daily workflow and leading the work of assigned staff. This role will mentor, coach, act as a resource and provide feedback on performance of assigned staff. Assist the Manager and provide guidance to staff with day-to-day System Application and Products (SAP) activities for processing provider claims payments, incentives, Capitation payments and Member out-of-pocket refunds for all Lines of Business(LOBS) are processed in accordance with LA Care regulatory policies and Generally Accepted Accounting Principles (GAAP) regulatory requirements. responsible for the daily workflow and leading the work of assigned staff. This role will mentor, coach, act as a resource and provide feedback on performance of assigned staff.

This position will review and approve daily payment, line level reconciliation between SAP, QNXT and Payspan to ensure accurate processing, audit provider (EFT) Electric Funds Transfer data by working with a third-party vendor, Payspan. Create financial activity reports, the daily SAP / QNXT claims processed report, weekly cash flow trends, and perform the SAP / QNXT month end financial reconciliation between QNXT / SAP and document variances at the payment level.

This position is responsible for expediting the process which includes proactive follow-up for documentation and approvals and scheduling support for Departmental Invoice meetings. This position involves answering questions for internal and external contacts / vendors. Assists with special Accounting Projects during audits as needed. This is a highly visible position, requiring interaction with all levels of the organization. The Lead acts as a steward throughout the process and is the key contact for questions and helps ensure compliance to relevant policies.