Accounts Receivable Specialist

🕒 2 days ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

💵 $24 - $27 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

💰 Accounts Receivable

👻 Ghost score 0%

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Community Care Cooperative (C3)

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2016

🏥 Healthcare

🤝 Non-profit

🌍 Social Impact

Healthcare • Non-profit • Social Impact

Community Care Cooperative (C3) is a rapidly growing non-profit created by Federally Qualified Health Centers (FQHCs) to strengthen primary care, improve financial performance, and advance racial justice. C3 unites health centers into FQHC-led accountable care networks, providing contracting, data, actuarial, and population-health capabilities to enable participation in value-based payment and care models. It also operates affiliates that deliver technology services (Community Technology Cooperative), pharmacy operations and 340B support (Community Pharmacy Cooperative), and a statewide telehealth consortium to help health centers integrate telehealth into primary and behavioral care.

📋 Description

• Enter and review charges for accuracy, ensuring proper coding and compliance with payer requirements • Utilize the charge router within Epic to route charges efficiently and accurately to the correct claim workflows • Identify and resolve charge capture errors or discrepancies to prevent billing delays • Prepare, review, and submit electronic and paper claims through Epic and various clearinghouses • Apply claim form logic to review and resolve formatting errors before submission • Liaise with insurance companies to resolve discrepancies, missing files, and claim rejections • Analyze UB-04 and CMS-1500 claim form logic to ensure proper billing practices • Monitor claims for timely submissions and address rejected or denied claims • Assist in managing accounts receivable by identifying trends in denials or delays • Perform payer appeals on denied claims as needed • Support billing workflows, payment posting, and reporting using Epic and other EHRs • Reconcile daily payment batches and resolve discrepancies • Monitor unapplied payments and resolve posting errors • Work with banking institutions on deposit processing and returned or rejected transactions • Handle inquiries related to payment posting and ERA processes • Generate and analyze payment posting and cash reconciliation reports • Maintain patient accounts and payer information • Collaborate with IT and billing teams on system-related billing issues • Ensure compliance with FQHC guidelines, Massachusetts healthcare regulations, and payer rules • Stay updated on coding guidelines, billing codes, payer policies, and industry best practices • Participate in internal and external audits • Partner with clinical, coding, and health information teams to resolve documentation issues • Address billing inquiries from insurance companies, patients, and stakeholders • Review billing dashboards to monitor performance metrics and denial trends • Provide workflow improvement feedback to leadership • Provide customer service for account inquiries and payment concerns • Perform other duties as assigned

🎯 Requirements

• Minimum of 3-5 years of experience in medical billing, preferably in an FQHC or professional billing setting • Knowledgeable of Massachusetts healthcare billing regulations and payer requirements • Proficiency in Epic resolute professional billing processes • Strong understanding of claim form logic and payer-specific billing requirements • Familiarity with Massachusetts healthcare regulations and insurance processes • Knowledge of medical coding (CPT, ICD-10, HCPCS) and compliance requirements • Excellent attention to detail, organizational skills, and the ability to meet deadlines • Strong communication and problem-solving skills • Solid communication skills across stakeholders, diligence, and problem-solving skills • Experience in Microsoft Office Suite • Must have a strong commitment to quality assurance and exceptional customer service • A strong commitment to C3’s mission • High school diploma or equivalent required • Associate or bachelor’s degree in business, healthcare administration, or a related field is preferred • Familiarity with the MassHealth ACO program • Familiarity working in Federally Qualified Health Centers (FQHC) • Experience with anti-racism activities, and/or lived experience with racism is highly preferred

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