Manager, Payment Operations
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AI Summary
Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. Our commitment and partnership means thinking beyond the typical solutions in the market – to do more for clients – and take them beyond the standard “Point A to Point B.” We have researched the most effective cost containment strategies and are driving down the cost of plans with innovative solutions such as, network and payment integrity, pharmacy benefits and care management. There are many companies with a mission. We are a mission with a company.
The Manager, Payment Operations is a finance-owned role responsible for leading all claims funding and check run operations across the Point C platform. This role sits within the Finance organization and serves as the primary owner of the end-to-end funding process, from check register generation through Echo transmission and custodial account management. The Manager will lead a team of funding specialists, drive the implementation and adoption of check run automation, and ensure operational readiness ahead of significant client volume growth.
Primary Responsibilities:
- Own the end-to-end claims funding process, including check register generation, Echo file transmissions, EOB template management, and custodial account reconciliation across all client groups
- Lead and develop a team of funding specialists; assign group portfolios, establish daily workflows, and ensure accuracy, timeliness, and compliance
- Drive the implementation and operationalization of check run automation within the VBA platform; serve as the internal subject matter expert
- Establish and monitor KPIs, SLAs, and quality controls for all funding operations; reduce error rates and client escalations
- Manage vendor relationships, including ECHO Health, for file transmissions and troubleshooting
- Partner with IT on system issues, automation enhancements, and platform migrations
- Develop and maintain SOPs, staffing models, and training materials for the funding team
- Support acquisition integrations and the consolidation of funding processes onto a unified platform
- Serve as the Finance liaison for all funding-related client inquiries, stop loss coordination, and claims register reviews
Qualifications:
- 5+ years of experience in claims funding, payment operations, or TPA finance operations
- 3+ years of leadership experience managing a team in a healthcare or TPA environment
- Hands-on experience with VBA as a claims and funding platform — required
- Experience with check run automation tools strongly preferred
- Familiarity with ECHO Health payment systems, HEALTHpac, and QicLink
- Deep understanding of the TPA funding cycle: check register generation, custodial account management, stop loss coordination, and Echo transmission
- Strong analytical, organizational, and communication skills
- Ability to build processes from scratch and manage through ambiguity in a fast-moving environment
Individual compensation will be commensurate with the candidate's experience and qualifications. Certain roles may be eligible for additional compensation, including bonuses, and merit increases. Additionally, certain roles have the opportunity to receive sales commissions that are based on the terms of the sales commission plan applicable to the role.
- Comprehensive medical, dental, vision, and life insurance coverage
- 401(k) retirement plan with employer match
- Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)
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Paid time off (PTO) and disability leave
- Employee Assistance Program (EAP)
Equal Employment Opportunity: At Point C Health, we know we are better together. We value, respect, and protect the uniqueness each of us brings. Innovation flourishes by including all voices and makes our business—and our society—stronger. Point C Health is an equal opportunity employer and we are committed to providing equal opportunity in all of our employment practices, including selection, hiring, performance management, promotion, transfer, compensation, benefits, education, training, social, and recreational activities to all persons regardless of race, religious creed, color, national origin, ancestry, physical disability, mental disability, genetic information, pregnancy, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, and military and veteran status, or any other protected status protected by local, state or federal law.
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