Payment Integrity Lead & Trainer

Description At HealthFund Solutions, we are an advocate for the uninsured and the underinsured patients and a partner to hospitals and healthcare providers. With decades of experience in the healthcare field, we observed a rising need to help a percentage of the population that continues to grow every day—those living without health insurance. Through sponsorship programs, Medicaid screening and premium monitoring, we empower patients to get the coverage and care they need to get back on their feet. Reporting to our Payment Integrity Manager, the Payment Integrity Team Lead trains new hires, approves payments and researches complex matters. Prior experience with insurance technology, medical background, and payment management of accounts, management/leadership experience, accounting, or financial experience necessary Benefits Medical, Dental, and Vision Insurance Life Insurance Short-Term and Long-Term Disability Critical Illness & Accident Plans 401(k) with up to 4% employer match Responsibilities Interact with Company departments and external vendors Send, receive, and review contracts with external vendors Update Company databases, with extreme attention to detail Work in compliance with banking portals Verify Insurance information on patient account for accuracy and contract compliance Assist in making patient insurance premiums payments Accurately record payments made in company database per outlined procedures Review exception reports Actively pursue refunds owed by insurance companies Act as back up to the Payment Integrity Manager Monitors inter- & intra-departmental communications (emails and teams) Researches and solves more intricate insurance/payment discrepancies and ensures follow through Assists with the auditing process to ensure all payments have been processed accurately and timely Assists with and oversees training new associates of Payment Integrity duties alongside Level II Back up to approving Payment System requests Back up to end of night or other reporting needs Assists with intradepartmental Onspring Ticket needs Assists with organizing in-office needs of Payment Integrity Team such as supplies/filing etc. Flexible to shift to alternate duty assignment based on timely needs of the team/volume Observes onsite staff daily to ensure acceptable work ethic and production Coaches team members daily or when needed for corrections/teachings Reports to Payment Integrity Manager all problem resolutions needing attention Assists Payment Integrity Manager by providing feedback for all team member reviews Provides the eyes and ears of the office staff to management whenever necessary Other duties as assigned Requirements High School Diploma required College Degree or some college preferred One (1) to two (2) years of experience with mentoring, training, leadership, or managerial experience required One (1) to two (2) years of experience in medical insurance invoicing and payment management of accounts is required One (1) to two (2) years of general accounting experience or financial experience required Organization skills Extreme attention to detail Process Initiative Ability to communicate effectively in speaking and writing Work effectively with individuals from diverse backgrounds Ability to establish and maintain effective working relationships Ability and desire to communicate effectively by telephone Perform operations in Microsoft Office Suite Physical Abilities While performing the duties of this job Ability to sit for long periods of time entering data into the computer Ability to occasionally lift up to 10 pounds Ability to concentrate and stay on task for long periods of time NOTE This job description is not intended to be all-inclusive. Duties may be adjusted as needed to meet organizational needs. All candidates must successfully pass a national background check and a 12-panel drug screening. HealthFund Solutions is a drug‑free workplace. We are an equal opportunity employer. All qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status #J-18808-Ljbffr HealthFund Solutions LLC