Team Lead, Claims Disbursement in Norfolk, VA at Beacon Health Options

Date Posted: 7/7/2018

Job Snapshot

Job Description

About the Position:

The Team Lead, Claims Disbursement is responsible for executing all functions associated with daily claims production check runs for Connects. Examines and allocates received funds to the appropriate client bank accounts.  Monitors daily ASO bank account balances. Authenticates and releases all eligible check runs. Reviews and determines all positive pay exceptions.  Validates and executes all stop payments. Investigates any possible fraud issues.  Invoices clients, maintains void and refund information on the client fund statements and all financial reporting for the client. Manages escalated issues via Corporate Finance mailbox and escalated issues via email pertaining to FlexCare.  Responsible for completing all customer service inquiries, to include processing of stop payments. Manages audit requests and the 1099 hotline.  Supports Claims Disbursement Supervisor and all Premium Billing functions, including backup for the FlexCare and Connects teams.  This position must strictly adhere to HIPAA regulations pertaining to all financial and PHI disclosures. The Team Lead position requires a level of security that includes live checks storage, MICR and software protection.  The Team Lead position will serve as a backup supervisor when needed.

Position Responsibilities:

  • Proof and post all claims transactions into the General Ledger Finance System of CAS.  Record totals for posting reconciliation. Review all scheduled clients to ensure their eligibility for processing in the daily check run.  Once verified execute check run processing for the clients.  Generate and transmit all positive pay files to appropriate bank.
  • Process all claim transactions in the FlexCare system.  Records totals for posting reconciliation. Reviews all scheduled clients to ensure their eligibility for processing in the daily check run.  Once verified execute check run processing for the clients.  Generates and transmits all positive pay files to appropriate bank.
  • Generate funding reports via secure internet website for ASO clients to include the beginning bank balance report, wire report and ACH report.  Examine and allocate received funds to the appropriate clients.  Investigate all discrepancies between funding report and fund statements.  Validate beginning balance report to ensure no accounts are in a possible overdraft situation and investigate and resolve or escalate findings.
  • Authenticate that daily check runs are funded correctly and eligible for release.   Release all authenticated check runs via secure outsourcing vendor website. Perform any reroutes as requested within the guidelines of the Finance Policy and Procedures.   
  • Review all positive pay exceptions via secure banking websites and decision all exceptions prior to banking deadline.
  • Validate all stop payment requests and execute via secured banking website.
  • Investigate any possible fraud issues; coordinate with the treasury department, and initiate formal bank investigations as necessary.
  • Responsible for all associated duties for assigned clients to include invoicing, reconciling fund statements, and processing special reporting as required.  All special reports must be validated against the check register and any discrepancies must be investigated and resolved prior to finalizing the invoice within the contractual time frame. All invoicing correspond must strictly adhering to HIPAA regulations pertaining to both Financial and PHI disclosures.
  • Manage all escalated issues within the Corporate Finance mailbox ensuring that all items are addressed within 48 hours.
  • Open and forward mail to the appropriate areas.
  • Examine customer service inquiries, investigating as necessary to perform check traces, stop payments and regeneration of financial documents within guidelines established in the finance policies and procedures
  • Support Claims Disbursement Supervisor as needed.  Manage supplies and order as necessary, including check stock, envelopes and general office supplies.  Serve as a backup (supervisor) when the Claims Disbursement supervisors are out of the office. 
  • Manage audit requests to ensure they are completed within required deadline
  • Manage 1099 hotline – log all calls and distribute work evenly to the finance staff for research and resolution.  Contact providers regarding 1099 inquires, researching raised issues and processing reconciliation reports as warranted.   Authenticate all names and TINs match Internal Revenue Service records.
  • Troubleshoot all inter-departmental requests regarding any issues as presented.
  • Monitor assigned client’s funding patterns according to the established guidelines in the finance policies and procedures. CPSIII is responsible for initiating all necessary actions for clients who fall outside the established guidelines.
  • Support all Claim Payment Specialist functions.
  • Act as a back-up for all Claims Payment functions, in the event of illness or vacations.
  • Participate in all conference calls related to new client implementation and current issues with all clients.

Position Requirements:

  • Education:  Some College Preferred
  • Relevant Work Experience:  Five years MS Excel experience to include data manipulation, creating reports, pivot tables, and using macros. 

To Apply:

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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disabled