Payment Posting and Claims Center Supervisor

Pure Infusion; Sandy (UT); Ibrido; USD 52.000 - 65.000; Tempo pieno

Vantaggi offerti da questo lavoro

401(k) Matching

Health, Vision, and Dental Insurance

Over 20 days of paid time off annually

Community service day

Descrizione del lavoro

Pure Infusion is seeking a Payment Posting and Claims Center Supervisor in Sandy, UT to lead daily operations for the Payment Posting and Claims Center teams. You will assign work, train staff, and ensure timely posting, accuracy, and quality across all revenue-cycle activities.

The role requires healthcare RCM experience, strong leadership, and collaboration with IT and Finance. The position is hybrid (3 days in-office) with competitive benefits.

Competenze

• Two or more years of healthcare revenue cycle experience, including payment posting and electronic claims processing.
• Proficiency with ERAs/835s, EFT and lockbox payments, claim transmission and clearinghouse acknowledgments, rejections, and contractual adjustments.
• Ability to coach employees, audit quality, analyze operational data, and elevate issues appropriately.
• Proficient in Microsoft Excel.
• Knowledge of HIPAA and billing compliance requirements.

Mansioni

• Direct daily work and staffing for Payment Posting and Claims Center teams; train, coach, and evaluate performance.
• Approve time, PTO, and overtime; participate in hiring decisions and corrective actions.
• Oversee accurate posting of ERAs/EOBs, EFTs, checks, patient payments, and adjustments; monitor cash posting and aging.
• Coordinate charge readiness and handoffs with other departments; perform routine quality reviews.
• Produce daily/weekly operational scorecards; manage vendor performance and remediation.
• Perform hands-on posting occasionally during backlogs; ensure HIPAA and policy compliance.

Conoscenze

Healthcare revenue cycle

Coaching and team leadership

Excel proficiency

Operational data analysis

HIPAA compliance

Cross-functional coordination

Vendor coordination

Adaptability (hybrid)

Formazione

High school diploma or GED

Strumenti

AdvancedMD

R2

EDI software

Descrizione del lavoro

Payment Posting and Claims Center Supervisor

Position Summary:

Reporting to the RCM Manager over Charge Entry, EDI, and Payment Posting, the Payment Posting and Claims Center Supervisor directs daily execution for Pure Infusion's Payment Posting and Claims Center teams. The supervisor manages the teams' daily operations and personnel, including work assignment, training, performance evaluation, hiring and corrective-action recommendations, and time approval. The supervisor is accountable for the teams' productivity, quality, and turnaround results, timely transaction processing, first-line exception resolution, quality audits, and accurate operational reporting. The RCM Manager retains ownership of departmental KPIs, capacity and staffing strategy, financial control design, SOP and system changes, vendor remediation, and systemic cross-functional escalations.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Team Leadership and Daily Execution

• Support, drive, and demonstrate daily the core values of Pure Infusion.
• Assign and direct daily work and staffing coverage for both teams, adjusting priorities as needed; lead huddles and use queue volumes, throughput, productivity, and aging data to direct the team.
• Train, onboard, and coach staff, and conduct performance evaluations against established standards.
• Approve time, PTO, and overtime within established guidelines.
• Interview candidates and make hiring recommendations to the RCM Manager. These recommendations carry significant weight.
• Document performance concerns and recommend corrective action, up to and including termination, in accordance with company policy.
• Be accountable for the teams' productivity, quality, and turnaround results.
• Enforce established SOPs, job aids, quality standards, and turnaround expectations; recommend improvements to the RCM Manager.
• Perform calibrated routine quality reviews of internal and vendor work; document errors, corrections, and recurring trends.

Payment Posting and Reconciliation

• Oversee accurate and timely posting of ERAs/EOBs, EFTs, checks, patient payments, copay assistance, grants, and approved contractual adjustments in AdvancedMD and R2, as applicable.
• Track daily receipts, posted and unposted amounts, unapplied and unidentified cash, and posting backlog by count, dollars, system, age, and owner.
• Coordinate operational matching of deposits, lockbox receipts, remittances, and posting records; research variances and provide documentation to Finance for reconciliation and month-end close. Finance retains bank reconciliation and close authority.
• Oversee accurate posting of approved adjustments and write-offs and validate supporting documentation. This role has no write-off approval authority; write-off approval remains with the RCM Manager or higher under the financial authority policy.
• Identify duplicate or misapplied payments, reversals, recoupments, overpayments, credit balances, refunds, and adjustment exceptions; route decisions and approvals to the authorized owner.
• Monitor posting timeliness and accuracy against approved targets; document root causes and elevate material or recurring issues.

Claims Center and EDI

• Oversee front-end claim edits, validation, electronic submission, clearinghouse processing, acknowledgments (including 999/277CA where applicable), payer acceptance, and timely correction of rejected or unsubmitted claims.
• Track claim holds, transmission failures, rejection queues, payer-specific edits, and aged claim-status items by system, payer, state, entity/TIN, dollars at risk where available, and assigned owner.
• Resolve first-line issues under approved SOPs; elevate payer enrollment, EDI/ERA configuration, TIN/NPI routing, recurring claim failures, and system defects to the RCM Manager with supporting evidence.
• Coordinate charge readiness and handoffs with Charge Entry, Billing/A/R, Payer Development, and IT. Downstream adjudication, denials, collection follow-up, and write-off authorization remain with their designated owners.

Reporting, Vendors, and Escalation

• Produce daily and weekly operational scorecards for the Claims Center/EDI and Payment Posting teams, including volume, accuracy, backlog movement, aging, exceptions, and vendor productivity; provide Charge Entry reporting as assigned.
• Oversee day-to-day outsourced vendor production and quality checks, document vendor defects, and elevate service failures. The RCM Manager owns vendor SLA remediation and capacity recommendations.
• Log exceptions with owner, age, known financial exposure, and next action; elevate matters that require policy changes, cross-department intervention, financial approvals, or system redesign.
• Perform hands-on payment posting or claims work only occasionally, such as during backlogs or staffing gaps, without displacing supervisory responsibilities.
• Refer suspected billing compliance, overpayment, or privacy concerns directly through established Compliance channels, without waiting for operational review.
• Ensure team compliance with departmental SOPs, HIPAA, and company policies.
• Perform other duties as assigned.

SUPERVISORY RESPONSIBILITIES

Directly supervises the assigned Payment Posting and Claims Center staff (currently six employees). Responsibilities include assigning and directing work, staffing coverage, training and coaching, quality review, performance evaluations, hiring recommendations, corrective-action and termination recommendations, and time, PTO, and overtime approval. Coordinates vendor workflows but does not directly supervise vendor employees.

Required Knowledge and Skills

• Two or more years of healthcare revenue cycle experience, including payment posting and electronic claims processing.
• Working knowledge of ERAs/835s, EFT and lockbox payments, claim transmission and clearinghouse acknowledgments, rejections, contractual adjustments, and payment reconciliation.
• Demonstrated ability to coach employees, audit quality, analyze operational data, and elevate issues appropriately.
• Proficiency in Microsoft Excel.
• Payment posting, reconciliation, and adjustment practices across government, commercial, and patient payers.
• Front-end claim processing, clearinghouse, and EDI workflows.
• Quality auditing, operational reporting, and exception management.
• Coaching and team accountability.
• HIPAA and billing compliance requirements.
• Cross-functional and vendor coordination.
• Ability to meet the hybrid work arrangement (three days per week in the Sandy, UT office).
• Ability to meet U.S. employment and eligibility requirements.

Education/Licensure/Technical Requirements

• High school diploma or GED required.
• Two or more years of healthcare revenue cycle experience, as described under Required Qualifications.

The pay range for this role is:

$52,000 - $65,000 USD per year (Sandy HQ)

About Pure Infusion

Pure Infusion is a fast-growing healthcare company and a leader in chronic-condition infusion therapy. We deliver a personalized, private, and meaningful infusion experience for patients who often need ongoing care and consistency. Pure Infusion has been recognized as one of Utah's fastest-growing companies, and we believe that growth is a reflection of our people, purpose, values, and patient-first culture.

Our patients are referred by specialty physicians for biologic and other infusion therapies, often related to autoimmune disorders or primary deficiencies. These patients need more than an appointment. They need a place that feels calm, professional, comfortable, and human.

Our Core Values

We live by four core values that define our culture and guide our hiring:

People-Obsessed

We care deeply about patients, teammates, referring providers, and every person who interacts with Pure Infusion.

Relentlessly Improving

We look for ways to make every visit, every process, and every interaction better than it was yesterday.

We are willing to challenge old healthcare assumptions and build a better model for patients and teams.

Grateful

We serve with humility, appreciate the people around us, and believe gratitude should turn into action.

Schedule and Benefits Snapshot

This is a Hybrid Position in Sandy, UT. Three days per week; remote work two days per week.

Our regular hours are generally Monday through Friday, 8 a.m. to 5 p.m., with most weekends and holidays off. In addition to a competitive salary, we offer:

401(k) Matching

Health, Vision, and Dental Insurance

Over 20 days of paid time off annually

One paid community service day each year to give back in a way that matters to you, either with your clinic, with the corporate team, or through a community cause you personally care about