Accounts Receivable Specialist

Title

Accounts Receivable Specialist

Director, Patient Financial Services

Individual Contributor

Boston (Hybrid)

V3.0; 9.9.25

Community Care Cooperative (C3) is a 501(c)(3) non‑profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast‑growing organization founded in 2016 and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices in Massachusetts and across the country.

We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.

We are seeking an experienced Accounts Receivable Specialist to join our revenue cycle team. The ideal candidate will have a strong background in professional billing or working in a doctor's office, with a preference for experience in Federally Qualified Health Centers (FQHC). The position requires a detail‑oriented and collaborative professional responsible for the implementation, configuration, optimization, and support of Epic’s Resolute Professional Billing (PB) module.

This role ensures accurate and efficient billing workflows, charge capture, claims processing, and reimbursement across the healthcare revenue cycle. Familiarity with Massachusetts healthcare regulations, electronic health records (EHRs), and related software is essential for success in this role.

• 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, ensuring compliance with FQHC billing guidelines and Massachusetts‑specific regulations
• 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 claim form logic, including UB‑04 and CMS‑1500 formats, to ensure proper billing practices are followed
• Monitor claims for timely submissions by working closely with follow‑up colleagues to 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
• Leverage Epic systems and other EHRs to support billing workflows, payment posting, and reporting
• Reconcile daily payment batches to ensure all funds are accounted for and discrepancies are resolved promptly
• Monitor unapplied payments and resolve posting errors in a timely manner
• Work with banking institutions to ensure accurate deposit processing and address returned or rejected transactions
• Function as a point of contact for inquiries related to payment posting and ERA processes
• Generate and analyze payment posting and cash reconciliation reports to identify trends and areas for improvement
• Maintain and update patient accounts and payer information in the system as needed
• Collaborate with IT and billing teams to address system‑related issues impacting billing processes
• Ensure billing practices comply with FQHC‑specific guidelines, Massachusetts healthcare regulations, and payer rules
• Stay updated on changes to coding guidelines, billing codes, payer policies, and industry best practices
• Participate in internal and external audits as required
• Partner with clinical, coding, and health information teams to resolve billing documentation issues
• Communicate effectively with insurance companies, patients, and other stakeholders to address billing inquiries
• Review billing dashboards as a tool to monitor performance metrics and identify denial trends
• Provide feedback to leadership on areas for improvement within billing workflows
• Communicate effectively with insurance…