Associate Director- Cash Posting

Guidehouse; San Antonio (TX); On-site; USD 120,000 - 150,000; Full time

Benefits offered by this job

Medical Insurance

Rx Insurance

Dental & Vision

Paid Holidays

401(k)

Life Insurance

Tuition Reimbursement

Employee Referral Program

Job summary

Guidehouse is seeking an experienced Cash Posting Associate Director to oversee teams handling daily cash posting and reconciliation for hospital revenue cycle operations. You will ensure payments, adjustments, and denials are posted accurately and timely, applying strong leadership in Epic and MEDITECH environments.

The role requires hands-on leadership, critical thinking, and expertise in hospital patient accounting systems to drive performance and regulatory compliance across departments.

Qualifications

• Requires a bachelor’s degree and 10 years of relevant experience.
• 5 years of healthcare revenue cycle, hospital cash posting, payment posting Epic, MEDITECH Magic, and/or MEDITECH 6.x/Expense experience.
• Of the 10 years of relevant experience, a minimum of four years must include people management.

Responsibilities

• Lead daily cash posting, payment reconciliation and related processes.
• Drive accuracy and timeliness of billing and collections in hospital revenue cycle.
• Ensure compliance with CPT4, HCPCS, revenue codes, and Medicare regulations.

Skills

Cash posting

Leadership

AR reconciliation

Critical thinking

Healthcare revenue cycle

Education

Bachelor's degree

Tools

Epic

MEDITECH Magic

MEDITECH 6.x/Expanse

Job description

Job Family: PFS General Travel Required: None Clearance Required: None

What You Will Do:

The Cash Posting Associate Director is responsible for overseeing the team or teams that handle the daily cash posting and payment reconciliation functions for hospital and healthcare revenue cycle operations. This position ensures that patient and payer payments, adjustments, denials, and other financial transactions are posted accurately, timely, and in accordance with established policies, procedures, and internal controls. The ideal candidate is a hands‑on leader with strong cash posting and reconciliation experience, excellent critical‑thinking skills, and experience working within hospital patient accounting systems, including Epic, MEDITECH Magic, and MEDITECH 6.x/Expanse environments.

Essential Job Functions

Leadership / Training Billing / Cash Posting / Collections Compliance Reporting Duties and Responsibilities Acts and leads in a manner that will instill trust and foster team play. Ensures that all employees know and understand all State and Federal Rules and Regulations. Ability to make good judgment and quick decisions, strong AR acumen Provide a working environment which allows employees to communicate ideas for improvement to department. Whenever possible request employee input on policies and procedures that may affect or impact the way their job is performed. Maintain open communications and provide appropriate feed back to PBA staff and management. Allow employees to attend seminars which will enhance productivity and knowledge. Ensures employees have all the tools necessary to achieve the goals set.

Billing/Cash Posting/Collections

Experienced in driving cash and AR account resolution. Working with all payers for resolution and escalation. Experienced with expected reimbursement variance management. Works with all departments to ensure accuracy of CPT4, HCPCS and Revenue Codes. Provide departments with Medicare and other payer updates, notices and coverage changes which effect both billing and reimbursement. Reviews process and systems to ensure the most effective methods are maintained to meet all departmental and facility goals. Works with IT to ensure that all changes are completed to ensure accuracy of billing is maintained. Ensures bill hold in electronic systems meets established goal. Works with both electronic billing vendor and payers to resolve billing/cash posting issues. Identifies and resolves problems in the patient accounts receivable process and when appropriate initiate changes to rectify payer issues, underpayments and denials. Reviews and approves credit arrangements, refunds, write-offs and adjustments on accounts and insures departmental and medical center policy regarding signature levels are followed. Manages all employees providing follow-up on third party and self-pay accounts post initial billing. Prepares, distributes, and presents daily, weekly, and monthly reporting packages as required. Monitors overall performance and productivity in department. Ensures all reports are completed timely. Acts as a technical resource for Medicare regulations and reimbursement. Ensures that all components of the Medicare Bad Debt Log and supporting documentation are complete. Oversees Completion of Bad Debt vendor reconciliation. Informs management of all compliance issues. Assigned special projects will be completed within the time frames given. Appropriately documents each account worked in patient accounting system. Ensures all established goals are met. Develops and executes projects to reduce aged A/R and enhance collections. Understand and manages client service level metrics and key indicators of revenue cycle performance. Develop and adhere to methods of KPI improvement.

Compliance

Communicates all compliance issues to Manager. Educates and ensures that all employees understand Compliance and appropriate procedure for reporting compliance issues for State, Federal and HIPAA. Attends pertinent seminars, internal and external and shares obtained information with staff and other appropriate departments. Reviews and maintain JACHO requirements for billing, cash posting and collections.

Reporting

Responsible for the weekly Key Indictor Reports Patient Accounting and Billing Scrubber reports to departments daily. Maintain logs by department for claims on hold status. Daily electronic and paper claim report. Other reports as requested by management.

What You Will Need:

• Requires a bachelor’s degree and a minimum 10 years of prior relevant experience. (Relevant experience may be substituted for formal education or advanced degree.)
• 5 years of healthcare revenue cycle, hospital cash posting, payment posting Epic, MEDITECH Magic, and/or MEDITECH 6.x/Expense experience
• Of the ten years of relevant experience required, a minimum of four years must include people management experience.

What Would Be Nice to Have:

• Solid understanding of healthcare revenue cycle.
• Demonstrated competency in working in teams and ability to effectively communicate with all levels.

What We Offer:

• Medical
• Rx
• Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account
• Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [e-mail]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or [e-mail]. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.

All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

Guidehouse is a global AI-led professional services firm delivering advisory, technology, and managed services to the commercial and government sectors. With an integrated business technology approach, Guidehouse drives efficiency and resilience in the healthcare, financial services, energy, infrastructure, and national security markets. Built to help clients across industries outwit complexity, the firm brings together approximately 18,000 professionals to achieve lasting impact and shape a meaningful future.