Accounts Receivable Specialist

Community Care Cooperative (C3)

. Enter and review charges for accuracy, ensuring proper coding and compliance with payer requirements .

Posted 10/27/2026full-timeRemote • Massachusetts • United StatesMid-LevelSenior💰 $24 - $28 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in medical billing processes, particularly within Epic, ensuring compliance with Massachusetts healthcare regulations and payer requirements. Proficient in analyzing claim forms and resolving discrepancies to optimize billing workflows and enhance revenue cycle management.

Highest-signal resume keywords

Epic Resolute Professional BillingMedical Coding (CPT, ICD-10, HCPCS)Massachusetts Healthcare RegulationsClaim Form LogicAccounts Receivable Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Charge Entry and ReviewClaims SubmissionPayment PostingDenial ManagementReconciliation of Payment BatchesPayer AppealsBilling Workflow SupportTrend Analysis in DenialsCompliance with FQHC GuidelinesElectronic Claims Processing

Soft Skills

Attention to DetailOrganizational SkillsStrong Communication SkillsProblem-Solving SkillsCustomer Service Orientation

Tools & Technologies

EpicMicrosoft Office SuiteClearinghousesEHR Systems

Industry Keywords

FQHCMassHealth ACO ProgramHealthcare Billing RegulationsPayer RequirementsQuality Assurance

About the role

Key responsibilities & impact

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

What you’ll need

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