Supervisor, Medical Payment Processing

Salary Range:  $67,186.00 (Min.) - $87,342.00 (Mid.) - $107,498.00 (Max.)

 

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
 

Job Summary

The Supervisor, Medical Payment Processing is responsible in supervising the daily activities of the cash disbursement process for QNXT Claims, ancillaries, providers’ incentives, Prop 56, Members & Providers' refunds, all other providers’ invoices, and capitation for all lines of business (LOB). Responsibilities include review of daily invoice uploads, auditing for accuracy of posted refunds  and adjustment memos, reconcile weekly cash requirements and provide reporting information for cash flow.

 

The position is responsible for the month end process and communicating the accruals related to these processes. The position is responsible for the coordination of multiple check writing systems. The position will ensure that it adheres to the GAAP, maintain and monitor closely the internal controls. The position will interact with multiple departments, such as, Claims, Information Technology I.T., facilities Management and Quality Improvement.

 

The position supervises all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.

Duties

Supervise staff , including, but not limited to: monitoring of day to day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others.

Responsible for reviewing and approving the daily payment, line level reconciliation between SAP, QNXT and Zelis to ensure accurate processing.  Audits the provider Electric Funds Transfer (EFT) data by working with a third party vendor.  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.

Oversee and review the daily cash disbursement journals for accuracy. Ensure internal controls are in placed and followed by staff.  Responsible for the reconciliation of weekly cash requirements and ensure timely completion and distribution to the appropriate staff.  

Responsible for the resolution of Provider and Member payment issues, month end close for all Lines of Business (LOBs) and Multiple systems including accruals.

Communicate and coordinate the payment process from multiple systems.

Review and update training manuals, policies, and procedures.

Ensure all 1099s are reported in accordance with the IRS regulations. Coordinates the Levy payments to IRS with Accounts Payable (AP).

Perform other duties as assigned.

Duties Continued

Education Required

Associate's DegreeIn lieu of degree, equivalent education and/or experience may be considered.

Education Preferred

Bachelor's Degree in Finance or Related Field

Experience

Required:

Minimum 4 years of Accounts Payable experience with 6 months to a year of experience in leading process, programs or staff, or as supervisor

 

Experienced In a fast-paced office setting with familiarity and proficiency with a computerized environment, particularly working with databases and producing reports.

 

Accounts payable or Accounting experience in a health plan/ managed care environment.

Skills

Required:

Excellent communication skills.

Excellent problem solving skills.

Excellent Microsoft office skills.

Knowledge of AP process and accounting accruals.

Knowledge of Generally Accepted Accounting Principles (GAAP).

Ability to write Policies and Procedures.

Ability to read, analyze and interpret senate bills, business periodicals, professional journals, technical procedures and governmental regulations.

Demonstrated critical thinking and problem solving skills.

Persuasion Skills:  Accounts Payable is a job that requires significant interaction with internal and external parties. It requires good inter personal relationship skills and patience to deal with irritated vendors, etc., employees and management on issues