Accounts Receivable (AR) Specialist

Description

At Capital Area Health Network, we are committed to more than just providing healthcare—we are dedicated to transforming lives through compassion, excellence, and purpose-driven service. As a valued member of our mission-focused medical team, you'll be part of a culture that fosters our CAHN Cares:
Compassion—We treat every person with dignity and fairness, embracing all and ensuring no one is alienated or discriminated against.
Accountability—We safeguard the confidentiality of our patients and staff and are transparent in reporting to stakeholders and the community.
Reverence—We answer a higher call to serve, uplift those in need, and create a community rooted in mutual respect and shared humanity.
Excellence—We are committed to continuous learning and professional development, ensuring the delivery of culturally responsive, high-quality care.
Stewardship—We responsibly manage our resources to benefit both the organization and the community we serve.

We offer comprehensive primary care, dental services, and behavioral health support to our patients, ensuring every individual receives the quality care they deserve, regardless of background or circumstance.

Our mission is clear: To deliver effective, accessible, and culturally responsive care, education, and advocacy that promote health and quality of life.
Discover a place where your work makes a difference. Discover Capital Area Health Network.

JOB SUMMARY
Capital Area Health Network’s Accounts Receivable Specialist is responsible for an extensive review of explanations of benefits, denials, and open accounts receivable. Under minimal supervision and according to established procedures, policies, and detailed instructions, provide exceptional support and service to the internal and external customers of Capital Area Health Network.  This position interacts daily with team members and other departments in an effort to quickly resolve outstanding account balances while enhancing the customer experience and promoting corporate integrity and compliance.

ESSENTIAL FUNCTIONS

•    Demonstrates the ability to analyze, resolve, and prevent insurance rejections and claim denials.  
•    Documents all responses and actions taken to reach claim resolution in the billing revenue cycle management system.
•    Reviews and resolves claim issues in assigned error processing and denial queues in the billing accounts receivable management system.
•    Prepares billing, as required, including registration of patient demographic information, verification of insurance eligibility, review of charges, performs functions to validate accuracy, enters charges into the accounts receivable management system, and assembles supporting documentation as needed.
•    Ensures claims are submitted to the appropriate responsible party within designated filing limit guidelines.
•    Exhibits strong communication skills and a positive attitude with internal and external customers.
•    Maintains thorough knowledge of third-party eligibility and claim inquiry tools and applications, requirements, and regulatory guidelines.
•    Audits all explanations of benefits to confirm appropriateness of patient responsibility to ensure correct registration, coding, payment/adjustment posting, and insurance processing of claims.
•    Processes remittance, payment, and other documentation, including scanning and submission of information, according to CACHN's policy and procedure.
•    Meets or exceeds departmental productivity standards consistently.
•    Selects priorities and organizes work and time to meet them in order of importance.
•    Recognizes and researches problematic trends regarding non-payment in an effort to implement preventive measures to increase the velocity of cash collections.
•    Informs the Revenue Cycle Manager of consistent issues as they occur and makes recommendations to improve departmental quality outcomes. 
•    Communicates any payor changes and updates to the Revenue Cycle Manager.
•    Participates as a team member by performing additional assignments not directly related to the job description when workload requires and as directed by management.
•    Maintains strictest confidentiality; adheres to all HIPAA guidelines and regulations.
•    Demonstrates attention to detail, initiative, and judgment.
 

Schedule:
Monday – Friday, the hours of operation, 8:00 am- 5:00 pm, with potential extended hours. 

EDUCATION AND EXPERIENCE

•    High school diploma or equivalent GED. CPB certification preferred. 
•    A comprehensive understanding of insurance requirements and regulations, contract benefits, credit and collection procedures, financial assistance programs, as well as familiarity with medical terminology, is required. A minimum of two years' experience preferred, but we will consider one year.
•    The job requires analytical and critical thinking ability to diagnose account issues and active listening skills to provide service excellence. In addition, the work requires demonstrated project and time management skills and an ability to work effectively over the phone and in a team environment.
•    Knowledge of insurance, coordination of benefits, and reimbursement policies, including HMO/PPO, Medicare, Medicaid, and other commercial payers.
•    Familiarity with CPT and ICD-10 Coding.

BENEFITS
You’re Benefits at Capital Area Health Network (CAHN):

We value our team, and it shows in our benefits. As a CAHN employee, you’ll enjoy:

Health Coverage
•    Medical Insurance
•    Dental Insurance
•    Vision Insurance
•    Secondary Gap Insurance
•    Prescription Drug Plan 
•    Supplemental Policies through Colonial Life

  Financial Security
•    Short-Term Disability
•    401(k) Retirement Plan with up to 3% Company Match
•    Employer-Sponsored Short-Term Disability 
•    Employer Paid Life and AD&D

Work-Life Balance
 
•    Paid Time Off (PTO) Accrued as of  Day 1
•    Self-Care Floating Holidays
•    8.5 Paid Holidays
Additional Support
•    Employee Assistance Program (EAP)
•    Public Service Loan Forgiveness
We’re committed to supporting your well-being, at work and beyond.

QUALIFICATIONS
To perform this job successfully, the employee must be able to perform each essential function, as well as meet the physical and mental requirements, satisfactorily. The requirements listed above are representative of the knowledge, skills, abilities, and other characteristics required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

DISCLAIMER
This position carries a high risk of exposure to infectious agents, including HIV, hepatitis, and TB. The above duties and responsibilities are essential job functions, subject to reasonable accommodations. All job requirements listed indicate the minimum level of knowledge, skills, and/or abilities deemed necessary to perform the job proficiently. This job description is not intended to be construed as an exhaustive statement of duties, responsibilities, or requirements. Employees may be required to perform any other job-related instructions, as requested by their supervisor, subject to reasonable accommodation.
 

Qualifications

Salary : $22 - $25