Cash Applications Manager

Cash Applications Manager – Anesthesia Revenue Cycle (Arizona) Location: Arizona (On-site) Department: Finance / Anesthesia Revenue Cycle Employment Type: Full-Time Position Overview We are seeking an experienced Cash Applications Manager with a strong background in healthcare and anesthesia billing to lead our cash posting and payment reconciliation operations for anesthesia services delivered in Arizona. This role plays a critical part in maintaining accurate financial records, ensuring compliance with Arizona and federal healthcare regulations, and supporting optimal cash flow in a complex, high-volume anesthesia revenue cycle environment. The ideal candidate has hands-on experience with Arizona payers, understands anesthesia-specific reimbursement methodologies, and is comfortable navigating payer behavior, enrollment requirements, and remittance inconsistencies common within the state. This role partners closely with Billing, Coding, AR, Credentialing, Compliance, and Finance teams to resolve discrepancies and continuously improve payment processes. Key Responsibilities Cash Applications & Daily Processing Oversee daily cash application for professional anesthesia services rendered in Arizona, including payments received via lockbox, checks, EFT, and ERA. Ensure accurate posting of payments to patient and payer accounts. Monitor daily deposits and ensure all payer payments are fully posted and reconciled. Allocation & Reconciliation Manage allocation of payments across anesthesia providers, facilities, and encounters, ensuring alignment with payer remittance advice and contractual terms. Perform daily EFT and ERA reconciliation to verify payments against bank deposits, ERA data, and billed anesthesia charges. Reconcile high-volume anesthesia payments involving multiple CPT/ASA codes, modifiers (AA, QK, QX, QY, QZ), and split or delayed payments. Payment Discrepancies & Clarifications Maintain and oversee Payment Clarification Logs to track unapplied payments, partial payments, underpayments, overpayments, and misapplied funds. Investigate anesthesia-specific discrepancies such as time unit reductions, bundling, medical necessity edits, payer carve-outs, and Arizona-specific payer policies. Coordinate with AR and Compliance teams on refunds, recoupments, takebacks, and post-payment audits. EFT/ERA & Clearinghouse Management Manage clearinghouse relationships supporting Arizona anesthesia billing operations. Oversee EFT and ERA enrollments for Arizona-credentialed anesthesia providers and facilities. Monitor enrollment status, ERA mapping accuracy, and payer connectivity issues to prevent cash flow disruptions. Leadership & Oversight Lead, train, and mentor cash posting staff with a focus on anesthesia and Arizona-specific workflows. Establish quality controls and conduct audits to ensure posting accuracy, compliance, and timeliness. Provide regular reporting to Finance and Revenue Cycle leadership on cash performance, payer behavior, and risk areas affecting Arizona operations. Qualifications Required Finance, Healthcare Administration, or related field (or equivalent experience). 5+ years of experience in healthcare cash applications or payment posting. Demonstrated experience in anesthesia or hospital-based professional billing, preferably within Arizona. Strong knowledge of anesthesia reimbursement, EFT/ERA processing, and clearinghouse operations. Proven ability to reconcile complex, high-volume payments across multiple Arizona payers. Strong attention to detail and excellent organizational and time-management skills. Ability to work independently as well as collaboratively within a team environment. * Preferred Prior experience managing or leading a cash posting or payment reconciliation team. Familiarity with Arizona commercial payers, AHCCCS-related processes (as applicable), and self-funded employer plans. Experience with anesthesia billing systems (e.g., AMD, Waystar, Change Healthcare). Understanding of CMS, ERISA, and No Surprises Act implications on anesthesia payment posting. Skills & Competencies Deep understanding of billing and Arizona payer behavior. Exceptional attention to detail and analytical problem-solving skills. Strong leadership and cross-functional collaboration abilities. Ability to manage high-volume, multi-facility anesthesia payments. Advanced Excel and financial reporting skills. Process-driven mindset focused on accuracy, compliance, and continuous improvement. Job Type: Full-time Pay: $30.00 - $40.00 per hour Expected hours: 40 per week Benefits: 401(k) Dental insurance Health insurance Paid sick time Paid time off Vision insurance Work Location: In person