Lead, Cash Operations

Advanced Rx Management; Town of Florida (NY); On-site; USD 90,000 - 120,000; Full time

Job summary

Advanced Rx Management LLC is seeking a Cash Operations Lead to oversee cash posting, payment reconciliation, unapplied cash, and related Revenue Cycle activities.

The role ensures payments are properly identified, posted, and reconciled across patient, claim, payer, and client accounts while monitoring productivity, resolving complex issues, and partnering with Revenue Cycle, Finance, Collections, and other departments to maintain cash reporting integrity.

Qualifications

• Minimum education: Associate degree or Bachelor's degree preferred.
• Minimum experience: 3 years in healthcare Revenue Cycle, cash posting, payment posting or reconciliation.
• Proficiency with Excel and data analysis.
• Experience with ERA/EFT reconciliation or similar processes is a plus.
• Strong leadership and communication skills.

Responsibilities

• Provide day-to-day leadership to the Cash team.
• Oversee timely and accurate posting of payments.
• Reconcile daily payments and ensure accuracy against postings.
• Research unapplied and unidentified cash and reconcile discrepancies.
• Maintain documentation supporting payment research and resolution; ensure HIPAA compliance.

Skills

Healthcare Revenue Cycle

Cash Posting

Payment Posting

Reconciliation

Excel skills

Team Leadership

Education

Associates degree

Bachelor's degree preferred

Job description

General Summary

The Cash Operations Lead will provide day-to-day leadership and oversight of cash posting, payment reconciliation, unapplied cash, payment research, and related Revenue Cycle activities.

The Team Lead is responsible for ensuring payments received by AdvancedRx are accurately and timely identified, posted, reconciled, and reflected within the appropriate patient, claim, payer, and client accounts.

This position will provide daily leadership to the Cash team, monitor productivity and quality, resolve complex payment issues, identify process gaps, and partner with Revenue Cycle, Finance, Collections, and other departments to ensure the integrity of cash reporting.

This candidate must have a strong understanding of healthcare payment posting and reconciliation and must be able to identify discrepancies between payments received remittance information, bank activity, and amounts posted within the Revenue Cycle system.

Primary / Key Essential Functions and Responsibilities

Cash Posting Operations

• Provide day-to-day leadership and direction to the Cash team.
• Oversee timely and accurate posting of payments received.
• Ensure payments are applied to the correct patient, claim, payer, client, and account.
• Monitor daily cash posting volume and completion.
• Review payment-posting exceptions.
• Ensure appropriate contractual adjustments, payer adjustments, and other transactions are accurately recorded according to established policies.
• Review complex or unusual payments requiring additional research.
• Ensure payment documentation is maintained appropriately.
• Identify delays or barriers preventing timely posting.
• Escalate material issues to the Revenue Cycle Manager.

Daily Cash Reconciliation |Cash Received → Cash Identified → Cash Posted → Cash Reconciled

• Reconcile daily payments received against payments posted.
• Review bank, EFT, ACH, check, credit card, lockbox, and other applicable payment activity.
• Compare remittance information to payment transactions.
• Identify discrepancies between deposits and system posting.
• Research missing payments.
• Research duplicate postings.
• Identify incorrect payment applications.
• Monitor outstanding reconciliation differences.
• Ensure reconciliation issues are resolved within established timelines.
• Escalate material or aging reconciliation differences.

Unapplied & Unidentified Cash

• Maintain an accurate inventory of unapplied cash.
• Maintain visibility into unidentified payments.
• Assign research responsibilities to team members.
• Monitor aging of unapplied cash.
• Research missing or incomplete remittance information.
• Coordinate with payers when additional payment information is required.
• Work with Collections when payment information must be researched at the claim level.
• Identify payments posted to incorrect accounts.
• Resolve unapplied balances within established turnaround times.
• Escalate high-dollar or aged unapplied cash.
• Identify recurring causes of unapplied cash and recommend corrective action.

Remittance & Payment Research

• Research EOBs, ERAs, EFTs, checks, and other payment documentation.
• Match remittance information to payments received.
• Identify missing EOBs or remittance documentation.
• Research payments covering multiple claims or accounts.
• Assist staff with complex payment allocation.
• Identify payer payment patterns creating posting issues.
• Work with internal departments to obtain missing information.
• Maintain appropriate documentation supporting payment research and resolution

Team Leadership & Performance

• Provide daily direction, support, and team huddles.
• Set and monitor productivity, quality, workload, posting volume, and turnaround expectations.
• Review individual performance and conduct routine quality audits.
• Provide real-time coaching, recognize strong performance, and identify training needs.
• Support onboarding and ensure adequate coverage for critical cash functions.
• Escalate persistent performance concerns and assist with documented improvement plans as needed.

Reporting

The Cash Operations Team Lead will provide Revenue Cycle leadership with consistent visibility into cash operations through:

• Daily Reporting: Cash received and posted; pending, reconciled, unreconciled, unapplied, and unidentified cash; posting volume and backlog; high-dollar exceptions; and significant payment discrepancies.
• Weekly Reporting: Cash received versus posted; reconciliation status; unapplied/unidentified cash aging; posting turnaround time; team productivity and quality; high-dollar items; and recurring payer/remittance issues.
• Monthly Reporting: Cash received and posted; reconciliation and posting accuracy; unapplied/unidentified cash; turnaround time; employee productivity; aging trends; unresolved discrepancies; and process improvement opportunities.

Controls & Compliance

• Ensure adherence to separation-of-duties, documentation, approval, and reconciliation requirements.
• Monitor and elevate unusual transactions, duplicate payments, overpayments, and material discrepancies.
• Support internal and external audits and maintain accurate supporting documentation.
• Protect confidential financial and patient information in accordance with HIPAA and organizational policies.

Education and/or Experience and Qualifications

Minimum Education: Associates degree or; Bachelors degree preferred

Minimum Experience: 3 years of healthcare Revenue Cycle, cash posting, payment posting, reconciliation, or related experience.

Preferred Qualifications

• Workers’ Compensation payment experience.
• Pharmacy Revenue Cycle experience.
• Personal Injury/PIP experience.
• Experience with complex payer remittances.
• Experience managing large volumes of unapplied cash.
• Experience with ERA/EFT reconciliation.
• Experience with cash automation or auto-posting.
• Experience working with Finance or Accounting on reconciliation.
• Experience developing payment-posting SOPs and controls.

Knowledge, Skills and Abilities

• Strong knowledge of healthcare payment posting.
• Experience researching EOBs, ERAs, EFTs, checks, and payment discrepancies.
• Experience reconciling healthcare payments.
• Understanding of unapplied and unidentified cash.
• Previous Team Lead, Senior Cash Poster, Senior Payment Poster, or similar experience preferred.
• Strong analytical and problem-solving skills.
• Strong attention to detail.
• Ability to work with high-volume payment activity.
• Strong Excel skills.
• Ability to manage multiple priorities and deadlines.
• Strong written and verbal communication skills.

Financial Responsibility

Yes

Management / Supervisory Authority

Yes

Physical Requirements

The physical requirements listed are representative of those necessary to perform the essential functions of the position. Depending on the role, employees may be required to sit, stand, walk, reach, handle or operate equipment, and occasionally bend, stoop, kneel, crouch, crawl, or lift and/or move up to 25 pounds.

Reasonable accommodation will be provided to qualified individuals with disabilities, as required by applicable law, to enable them to perform the essential job functions either unaided or with assistance of a reasonable accommodation as determined on a case-by-case basis.

Standard Specifications

This job description describes the general nature and level of work and is not intended to be an exhaustive list of all duties, responsibilities, or requirements. Duties and responsibilities may change based on business needs. Employees may be assigned other job-related duties as needed.

This description does not create an employment contract, express or implied, or alter an at-will employment relationship, where applicable.

Equal Employment Opportunity

Advanced Rx Management LLC is an Equal Employment Opportunity (EEO) employer. We are committed to providing equal employment opportunities to all qualified applicants and employees without regard to legally protected characteristics under applicable federal, state, or local law. We provide reasonable accommodation to qualified individuals with disabilities and for other legally protected needs, as required by applicable law.