Accounts Receivable Specialist

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Full Time Boston, MA, US

Salary Range: $24.14 To $27.76 Hourly

Title: Accounts Receivable Specialist

Reports to: Director, Patient Financial Services Classification:Individual Contributor Location:Boston (Hybrid)

Job description revision number and date: V3.0; 9.9.25

Community Care Cooperative (C3) is a 501(c)(3) non-profit multi-service organization 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 fulfill two primary business functions for the FQHCs we work with. First, we are an FQHC-led accountable care organization (ACO); second, we are a Management Services Organization (MSO) for FQHCs.

As an ACO, we negotiate value-based payor contracts on behalf of our FQHCs, hold and operate those contracts (including fulfilling many compliance, financial management, and population health management functions), and maximize the return to FQHCs of any incentive dollars earned. We are proud to be the market leader in the Mass Health ACO Program. We are the largest Medicaid ACO in Massachusetts, and we operate a variety of business offerings nationwide.

As an MSO, we (along with our subsidiary companies, which are also FQHC-led non-profits) provide several financial, operational, and technological services to groups of FQHCs. These services include Epic EHR licensing and implementation; pharmacy operations consulting as well as the building and direct operation of on-site retail pharmacies; billing and credentialing; employer-sponsored insurance; and others.

We are a fast-growing, dynamic 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…