Panoramic Health
Come Join our team!!
The Manager, Payment Integrity is responsible for creating policies, workflows, and overseeing all RCM-related payment receipts and reconciliations. This position requires an experienced manager who can develop and implement policies, procedures, workflows, automations, and reports to ensuring the efficient handling and integrity of correspondence related to EOBs, payments, deposit batch reconciliations, and bank reconciliations. Oversight and responsibility for all refunds, takebacks, overpayments, and underpayments is also the responsibility of the Payment Integrity Manager.
Responsibilities include:

• Developing and supporting approved policies, procedures, workflows, and reports for the management of all payments related to claims, including time-of-service, payer, and patient payments.
• Managing a team of Revenue Resolution Specialists who receive the daily cash deposit batches and detailed back-up from all physician practices, research all “unpostable” transactions (Athena), post all payments (non-Athena systems), reconcile payments posting with the EMR and Bank Deposits, research all over/underpayments, and preparing refund requests for approval, and make claims corrections as needed to close out a claim to an accurate resolution.
• Overseeing the payor and patient refund operations, preparing refunds for Director approval, and sending check requests for approved refunds.
• Overseeing and aiding the reconciliation of all EMR activity to receipts, including reconciling time of service payments, lockbox payments, and other payments to the proper bank deposits.
• Ensure timely, accurate application of insurance and patient payment and adjustments received.
• Reporting discrepancies and aiding Finance in preparing statements to prove to providers PH’s accounting of revenue received, posted, deposited, and reconciled.
• Assisting with the Payment management set up for new practices integrating into RCM whether on Athena or another EMR.
• Advising RCM on process improvements that resolve the root causes of chronic problems, streamline, or automate the process, and improve the results significantly.
• Perform other duties and responsibilities as needed, assigned, or requested

Qualifications:

• College degree in finance, accounting, or equivalent work experience
• Proven experience with detailed reconciliations
• Experience with financial reconciliations
• Experience with managing teams to a target performance
• Experience hiring, developing staff
• Exceptional skills with EMRs and other systems related to financial reconciliations
• Exceptional analytical skills – Excel, Access, etc. Experience with Cash Management in a healthcare setting is preferred
• Knowledge of Athena, EPIC, AdvancedMD or other EMR is preferred
• Proven ability to perform formulas, vlook-up, pivots, and other Excel skills is required.

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