Operations Team Lead (Payment Posting)

Description

Job Overview

The Operations Team Lead is responsible for guiding and mentoring other posters while assisting with working a portfolio of the team's clients. This role ensures accurate and timely posting of both insurance and patient payments, adjustments etc. The Team Lead may manage the day-to-day tasks of ensuring all money is posted to the appropriate account within the host system or clearinghouse. Serves as the first point of escalation for complex payor issues. They are expected to balance daily postings to the client financial reports. Maintain the highest standards of quality, productivity, and compliance while driving both individual and team performance.

Requirements

Job Duties and Responsibilities

• Mentor assigned posters, providing continuous feedback to promote improved productivity and effectiveness of their work efforts.
• Serve as the first point of escalation for difficult payor issues or understanding complex EOBs.
• Assist in assigning daily work to team members based on priority, complexity, and individual skill sets.
• Ensure timely follow-up on unposted money and adherence to payer guidelines while meeting established performance expectations.
• Handle issues requiring advanced payer knowledge, contract review, and multi-step resolution processes.
• Post payments in accordance with Federal, State, and payer guidelines.
• Minimize claim denials and returns due to controllable errors by ensuring correct submissions.
• Stay current with payer updates and process changes for precise claim management.
• Work with client IT on trends to enhance more electronic posting.
• Communicate payer-specific issues to the team and management.
• Lead and contribute to daily shift briefings.
• Support onboarding new hires.
• Perform additional assigned tasks as required.
  
  

Qualifications

• High school diploma or equivalent required; Associate degree preferred
• HFMA CRCR certification or completion of certification required within 90 days of hire.
• Minimum 2 years of experience in Payment Posting EFT/ERA and manual for either hospital or Physician
• Mentoring experience required.
• Experience using EMR systems and Clearinghouse platforms
• Proficiency in Microsoft Office Suite, Teams, and various desktop applications.
  
  

Knowledge, Skills, And Abilities

• Knowledge of payor guidelines for posting insurance payments.
• Understanding of Healthcare Revenue Cycle administration rules and regulations.
• Knowledge of ICD-10 diagnosis and procedure codes as well as CPT/HCPCS codes.
• Strong investigative skills to identify and resolve insurance EOB discrepancies.
• Proficiency in computers and Microsoft Office Suite/Teams, with experience using GoToMeeting/Zoom.
• Ability to make informed decisions and take appropriate action.
• Demonstrates a positive attitude and pleasant demeanor at work.
• Willingness to learn, grow, and respond constructively to feedback for continuous improvement.
• Professional interaction with colleagues and punctual, dependable work habits.
• Ability to adapt easily to change and perform duties with ethical decision-making.
• Demonstrates accountability, responsibility, and accomplishments in the revenue cycle process