Accounts Receivable Specialist

Bay Cove Human Services’ mission is to partner with people to overcome challenges and realize personal potential. Bay Cove pursues this mission by providing individualized and compassionate services to people facing the challenges associated with developmental disabilities, mental illness, substance use disorders, and homelessness at more than 175 program sites throughout Greater Boston and Southeast Massachusetts. Reports to: Senior Director of Revenue Cycle Job Summary: Reporting to the Senior Director of Revenue Cycle, the Accounts Receivable Specialist is responsible for working with other Revenue Cycle staff, payers, and clients to ensure that payment for services is received in a timely manner. Additional responsibilities include ensuring that client demographic and insurance information is accurate and up to date, as well as maintaining the accuracy and timely posting of incoming payments from both insurance companies and clients. The Accounts Receivable Specialist is also responsible for investigating financial and administrative irregularities to ensure accurate revenue capture. This is a non-exempt position. Personal Characteristics: Demonstrated ability to work effectively and collaboratively with a culturally diverse population. Proficient communication, documentation, organizational, and presentational skills. Ability to be flexible, open, and responsive to ongoing changes. Qualifications: Bachelor’s degree or equivalent experience. Must have five or more years of experience reviewing client accounts and collecting and applying client payments. Knowledge of Microsoft Excel (Advanced), Outlook (Intermediate), and Word (Intermediate). Must be detailed oriented with strong investigative, interpersonal, relationship-building, analytical, problem solving, and time management skills. Key Responsibilities: Work closely with department leadership to investigate financial anomalies and barriers to claims adjudication. Support initiatives to drive efficiencies around revenue recognition and reporting processes. Collaborate with operation teams to explain what impacts revenue and provide indicators of changing processes. Identify and address potential collection/payment compliance issues and make recommendations to resolve. Offer insights and expertise to suggest ways of improving organization-wide collection/payment operations. Prepare and submit corrected claims to various insurance companies either electronically or by paper to obtain payment; produce self-pay statements, when applicable. Rebill denied or rejected claims before the insurance payer’s timely filing deadlines to facilitate payment; promptly appeal denied or rejected claims to obtain reimbursement. Present recommendations on operational improvements to enhance the efficiency of RCM processes to reduce denials and optimize overall collection/payment process. Respond to account-related questions and correspondence (mail, email, telephone calls, etc.) from staff, insurance carriers, and clients. Identify and document denial patterns, report findings to Senior Director of Revenue Cycle and rebill denied claims accordingly. Accurately redistribute unallocated payment amounts to other outstanding dates of service before processing refunds. Recommend and prepare accounts for outside collection agencies, attorneys, and write off, as applicable. Coordinate documentation for internal and external auditors; assist accounting department with resolving G/L variances. Collaborate with Senior Director of Revenue Cycle and department manager in the development and maintenance of A/R Standard Operating Procedures (SOPs). Maintain the confidentiality of all company and patient information at all times, as required by the facility and HIPAA guidelines. Other Requirements: Ability to manage accounts receivable and meet established monthly closing deadlines. Establish and maintain strong client relationships. The capacity to remain highly organized while managing multiple priorities and projects using the appropriate A/R methodologies and tools. Ability to systematically analyze problems, draw relevant conclusions and devise appropriate course of action. Under the guidance of the Senior Director of Revenue Cycle, work special revenue cycle projects. Complete other duties and relevant tasks as assigned. An acceptable CORI (criminal offender record information). Supervisory Responsibilities: None *Bay Cove Human Services is an Equal Opportunity Employer and does not discriminate on the basis of race, ethnicity, religion, sex, gender identity or expression, national origin, sexual orientation, disability, age, veteran status, or any other groups as protected by Massachusetts or federal law. All qualified candidates, regardless of background, are encouraged to apply.* *Bay Cove Human Services does not offer visa sponsorships at this time and will require candidates to be authorized to work in the United States.* Pay Range: $32.69 - $33.65 Hourly #J-18808-Ljbffr