Manager, Check Run- Nashville TN- Hybrid bei Lucent Health

About Lucent Health 

Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. 

Company Culture 

We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking.  These values are the foundation of Lucent Health. 

Honest 

• Transparent Communication: be open and clear in all interactions without withholding crucial information 
• Integrity: ensure accuracy in reporting, work outputs and any tasks assigned 
• Truthfulness: provide honest feedback and report any issues or challenges as they arise 
• Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior 

Ethical 

• Fair Decision Making: ensure all actions and decisions respect company policies and values 
• Accountability: own up to mistakes and take responsibility for rectifying them 
• Respect: treat colleagues, clients and partners with fairness and dignity 
• Confidentiality: safeguard sensitive information and avoid conflicts of interest 

Hardworking 

• Consistency: meet or exceed deadlines, maintaining high productivity levels 
• Proactiveness: take initiative to tackle challenges without waiting to be asked  
• Willingness: voluntarily offer to assist in additional projects or tasks when needed 
• Adaptability: work efficiently under pressure or in changing environments 

Summary:

The Manager- Check Run oversees and manages the end-to-end process of generating, reviewing, approving, and distributing claim payment checks and electronic funds transfers (EFTs) for a health insurance organization. This role ensures accuracy, compliance with regulatory requirements, timeliness of payments, and coordination across finance, claims, and IT teams. They are responsible for safeguarding the integrity of payment processes, maintaining proper audit documentation, and ensuring that payments are issued according to plan sponsor agreements and company policies. 

Responsibilities: 

• Plan, schedule, and execute weekly, bi-weekly, and ad-hoc check runs for provider, member, and vendor claim payments. 
• Review and reconcile payment batches to ensure accuracy of amounts, payee information, and claim data. 
• Coordinate with claims operations to resolve any discrepancies prior to payment release. 
• Oversee the generation of both physical checks and EFT/ACH transactions. 
• Ensure all check runs comply with federal, state, and plan-specific payment regulations. 
• Maintain detailed documentation for internal controls and external audits (e.g., HIPAA, SOC, NAIC). 
• Manage positive pay files and coordinate with banking partners to prevent fraud. 
• Serve as the primary liaison between Claims, Finance, IT, and banking partners for payment processes. 
• Communicate payment schedules and any delays to internal stakeholders. 
• Support vendor and provider inquiries related to payment status or issues. 
• Develop and maintain standard operating procedures (SOPs) for check run and payment processes. 
• Identify opportunities to streamline workflows and improve payment accuracy and timeliness. 
• Implement automation or system enhancements in coordination with IT and software vendors. 
• Oversee payment processing staff (if applicable), providing training, guidance, and performance feedback. 

Qualifications: 

• Bachelor’s degree in Finance, Accounting, Business Administration, or related field; or equivalent work experience. 
• 3–5 years of experience in payment processing, accounts payable, or claims finance operations in a health insurance or healthcare environment. 
• Strong understanding of healthcare claims payment cycles, EOB/EOP generation, and provider/member payment regulations. 
• Familiarity with HIPAA and other healthcare compliance requirements. 
• Proficiency with claims administration systems and accounting software (e.g., Facets, QNXT, Javelina, Great Plains, etc.). 
• Strong attention to detail and accuracy. 
• Excellent communication and organizational skills. 

Preferred Qualifications: 

• Supervisory experience. 
• Experience with positive pay processes and fraud prevention tools. 
• Knowledge of electronic payment file formats (ACH, 835/ERA, 837). 

Equal Employment Opportunity Policy Statement 

Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.