Lead Medical Payment Processor

Lead Medical Payment Processor

Los Angeles, CA (Onsite)

6-Month Contract

Job ID 2023-9163

Solugenix is assisting a client, a health insurance company, in their search for a Lead Medical Payment Processor. This is a 6-month contract opportunity based out of Los Angeles, CA (Onsite).

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 the 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 client regulatory policies and Generally Accepted Accounting Principles (GAAP) regulatory requirements. Responsible for the daily workflow and leading the work of assigned staff.

Qualifications:

  • Associate’s Degree. Preferred: Bachelor’s degree in Business Administration or Finance.
  • Instead of a degree, equivalent education and/or experience may be considered.
  • At least 0-2 years of Accounts Payable. 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 environment Able to work independently, accurately, and promptly without supervision.
  • A least 3 years of lead experience.
  • Preferred: SQL experience.

Responsibilities:

  • This position will review and approve daily payment, line level reconciliation between SAP, QNXT, and Pay span to ensure accurate processing and audit provider (EFT) Electric Funds Transfer data by working with a third-party vendor, Pay span.
  • Create financial activity reports, the daily SAP/QNXT claims processed report, and 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 is the key contact for questions and helps ensure compliance with relevant policies.

Required Skills:

  • Knowledge of the AP process is also critical as the position will be instrumental in maintaining the flow of documents through the AP department.
  • Excellent organizational skills.
  • Demonstrated ability to work effectively in a team environment.
  • Excellent verbal and written communication skills.
  • Excellent computer skills, and good knowledge of Microsoft Excel and Word.
  • Ability to multitask.
  • Preferred: SAP and QNXT knowledge.

Pay Range for CA, CO, IL, NJ, NY, WA, and DC: $29.22/hour to $36.51/hour. Starting rate of pay offered may vary depending on factors including but not limited to, position offered, location, education, training and/or experience.

About the Client

Our client is one of the world’s leading health insurance company based out of Los Angeles, CA.

About Solugenix

Solugenix is an information technology services company known for its deep experience and knowledge in providing comprehensive technology services, solutions, and talent support for companies around the world. The company offers a variety of cutting edge and talent support solutions to promote growth and cutting-edge advancement to our esteemed clients and candidates. We provide these talent support solutions on a contract, contract-to-hire, and direct hire basis. We also have additional resources from our staffing partners to ensure the right match and expertise for the best result.

For over 50 years, global and local brands have trusted Solugenix as an added resource and partner in taking steps to ensure their immediate and future success. In addition to generating ground-breaking, industry-defining solutions, Solugenix has been delivering the talent and support needed to make it happen. We are dedicated to partnering with clients and candidates whose core values also foster a culture of professionalism, teamwork, and integrity.

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