<p><p><b>Job Roles & Responsibilities:</b><br/><br/></p><p>- Design, implement, and manage a comprehensive payment reconciliation process for healthcare receivables.<br/><br/></p><p>- Oversee accurate and timely payment posting across multiple payers, platforms, and banking channels.<br/><br/></p><p>- Reconcile payments against 835 remittance files, bank statements, and internal accounting systems.<br/><br/></p><p>- Collaborate with RCM, finance, and IT teams to resolve discrepancies and optimize reconciliation workflows.<br/><br/></p><p>- Develop and maintain standard operating procedures (SOPs), audit documentation, and reconciliation reports.<br/><br/></p><p>- Ensure compliance with HIPAA, CMS regulations, and payer-specific guidelines.<br/><br/></p><p>- Interface with banks and financial institutions to manage ACH, EFT, lockbox, and wire transfer processes.<br/><br/></p><p>- Lead initiatives to automate and streamline reconciliation using tools and technologies.<br/><br/></p><p>- Provide strategic insights and reporting to leadership on reconciliation performance and trends.<br/><br/></p><p>- Train and mentor junior staff on Requirements:</b></p><p><br/></p>- Minimum 10+ years of experience in healthcare payment posting and reconciliation.<br/><br/></p><p>- Strong understanding of 835/837 files, ERA/EFT workflows, and payer-specific nuances.<br/><br/></p><p>- In-depth knowledge of banking systems, including transaction formats and reconciliation protocols.<br/><br/></p><p>- Proven experience in setting up and scaling reconciliation processes from the ground up.<br/><br/></p><p>- Advanced proficiency in Excel, reconciliation tools, and RCM platforms (e.g., Epic, NextGen, eClinicalWorks).<br/><br/></p><p>- Excellent analytical, problem-solving, and communication Qualifications:</b></p><br/></p><p>- CPA certification with experience in healthcare finance or revenue cycle operations.<br/><br/></p><p>- Experience with automation tools and RPA in reconciliation workflows.<br/><br/></p><p>- Familiarity with denial management, cash application, and financial reporting.<br/><br/></p><p>- Prior experience in a BPO, healthcare provider, or payer Note:</b> At Credence, we uphold the highest standards of integrity in our recruitment process.
We do not charge any fees at any stage of the hiring process, and we strictly prohibit any third parties, vendors, or individuals from soliciting money in exchange for job opportunities at Credence.</p><p><br/></p>If you are approached by anyone requesting payment or offering you a position at Credence in exchange for money, do not engage with them.
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