Accounts Receivable Specialist

BENEFITS:
At Wingspan, we prioritize our employees and their wellbeing. We provide competitive benefit options to our employees and their families, including domestic partners and pets.


Our offerings include:

• Healthcare: Comprehensive medical (free option available), dental, vision & FSAs
• Education Perks: 50% CWRU MSW tuition discount & free supervision for licensed roles
• Financial Security: 403(b) retirement plan with employer match
• Work-Life Balance: Generous PTO, paid holidays, and 24/7 EAP support
• Family Care: Fertility/IVF coverage, childcare FSA, and pet insurance

QUALIFICATIONS:

1. Education: Associates degree in accounting, finance, healthcare administration, or related field required. In lieu of a degree, a High School Diploma combined with 4 years of equivalent experience required.
2. Competency/Skills:
   • Working knowledge of medical billing, CPT/ICD-10 coding, and insurance processes (EOBs, 835s).
   • Core Expertise: Possess skill, knowledge and abilities to perform the essential duties of their role; keeps knowledge up to date.
   • Independent Judgment: Demonstrate ability to perform job responsibilities with a high degree of initiative and independent judgment.
   • Cultural Competency: Demonstrate awareness, sensitivity and skills in working professionally with diverse individuals, groups and communities who represent various cultural and personal background and characteristics.
   • Interpersonal Communication: Communicate clearly using verbal, nonverbal, and written skills in a professional context; demonstrates clear understanding and use of professional language.
   • Professional & Ethical Conduct: Adhere to professional values such as honesty, personal responsibility, and accountability; Applies ethical concepts within scope of work and adheres to Agency policies and procedures.
   • Collaboration and Teamwork: Function effectively as a member of a professional team that includes employees, clients and family members. Ability to adapt to multiple AR roles, providing flexible coverage and cross-training.
   • Problem Solving & Decision Making: Recognize problems and responds appropriately; gathers information and sorts through it to identify and address root cause issues; makes timely decisions. Ability to solve practical problems and handle variables in non-standardized situations, interpreting instructions in written, oral, diagram, or schedule form.
   • Service Orientation: Anticipate, recognize, and meet the needs of others, whether they are clients or not.
   • Technical Proficiency: Demonstrate competence in utilizing Agency computer systems and software as required to perform essential job functions. Proficiency in EHR systems (e.g. Netsmart), other billing applications, and MS Office (Excel for reports, Word for documentation, Outlook for correspondence).
3. Experience:
   • Minimum 4 years of experience in medical billing, accounts receivable, or revenue cycle management, preferably in behavioral health or healthcare.
   • At least 2 years of experience with Medicaid, MCOs, or Aetna OhioRISE billing processes, including familiarity with denials and cash posting.
   • Experience with multi-system reconciliation (e.g. Netsmart, Great Plains) and payer portals highly desirable.
   • Prior experience with report preparation, workflow documentation, or audit support preferred.
4. Certifications: Certification in medical billing/coding (e.g., CPC, CPB) preferred but not required.
5. Work Requirements: Must commute to office 5 days/week, 8 hours/day (no remote/hybrid). Ability to work under pressure, meet audit/month-end deadlines, and maintain high accuracy.

AGENCY SUMMARY:
Wingspan Care Group is a nonprofit administrative and management organization that provides a united, community-based network of services so member agencies can focus on mission-related goals. Our innovative model is designed to promote sustainability and advancement among its partner agencies by streamlining operations and eliminating redundancies resulting in improvements to the delivery of direct service operations.

JOB SUMMARY:
The AR Support Specialist plays a pivotal role in supporting Wingspan Care Groups revenue cycle operations by providing flexible coverage across accounts receivable, cash application, denial management, and non-Medicaid billing functions for five behavioral health agencies. Primarily working alongside Accounts Receivable and Medical Billing Specialists, the AR Support Specialist manages claims submission and follow up for Medicaid/MCO/Aetna OhioRISE claims. Further, the AR Support Specialist processes invoices and follows up on past due balances for school based and residential programs. This role also performs weekly cash application tasks (e.g., posting $0 ERAs), supports audit selections, and assists with month-end close. The Specialist cross-trains in light duties from the Denial Management Specialist, including report preparation, meeting minutes, workflow/policy documentation, and paper invoice creation, ensuring redundancy and future coverage.

ESSENTIAL DUTIES:

1. Primary AR Support:
   • Assist Accounts Receivable and Medical Billing Specialists in processing claims for billing, conducts follow-up on unpaid acocunts, and unbilled claim resolution.
   • Verify eligibility, update service authorizations, and correct clinician errors (e.g., documentation gaps) to ensure accurate claim submissions, supporting AR Specialists daily tasks.
   • Follow up on pending claims via payer portals or phone, resolving payment delays.
2. Cash Application Support:
   • Perform weekly cash application tasks (~4 hours/week), including posting $0 ERAs (835s) and processing payments (checks, EFTs, ACHs) across multiple systems (e.g., Netsmart, Great Plains), supporting the Cash Application Specialist.
   • Reconcile daily payment batches to bank statements, and report discrepancies to the AR Manager.
   • Update patient demographics in billing systems, assisting with credit card deposits as needed.
   • Research credit balances and patient accounts to identify refund eligibility (e.g., insurance overpayments, patient refunds), preparing documentation and letters for processing.
   • Assists with processing credit cards for payments on deductibles/ copayments or other open balances.
3. Denial Management Assistance:
   • Support the Denial Management Specialist by running denial reports and preparing data for appeals, such as pulling medical records or EOBs, without drafting or submitting appeals.
   • Assist in documenting denial trends and preparing training materials for AR Specialists to prevent denials, targeting <5% denial rate.
   • Log communications with payers for appeal tracking, ensuring audit-ready records.
4. Senior Coordinator Cross-Training:
   • Cross-train in non-Medicaid billing tasks, assisting with paper invoice creation for school tuition, residential programs, or cost-based reimbursements as needed, under Senior Accounts Receivables Coordinator guidance.
   • Help document AR team workflows and policies, ensuring clarity for training and retirement transitions, and prepare meeting minutes for bi-weekly revenue cycle sessions.
   • Run AR aging reports for non-Medicaid accounts, logging collection efforts for overdue balances, supporting Senior Coordinators reconciliation tasks.
5. Audit and Month-End Close Support:
   • Pull required selections (e.g., denial records, payment batches, invoices) during internal and external audit periods, ensuring compliance with Ohio Medicaid, HIPAA, and fiscal regulations.
   • Assist with month-end close by preparing AR aging, payment, and denial reports, reconciling data with Accounting for journal entries.
   • Support audit readiness by organizing chronological batch files and correspondence for all AR functions.
6. Process and Workflow Documentation:
   • Assist in creating and updating workflow/policy documents for AR, cash application, denial management, and non-Medicaid billing, ensuring consistency across teams.
   • Prepare materials for AR Managers training sessions, such as denial prevention guides or billing checklists, enhancing team competency and coverage.
7. Collaboration and Coverage:
   • Provide backup coverage for Accounts Receivable and Medical Billing Specialists, Cash Application Specialist, and Senior Coordinators during absences or peak periods, ensuring continuity.
   • Collaborate with clinical staff to gather documentation for billing/appeals and with IT to test AR systems (e.g., Netsmart, Etactics, Great Plains, PaperSave), supporting Senior Coordinator tasks.
   • Attend bi-weekly revenue cycle meetings, taking minutes and tracking action items for AR Manager.
8. Compliance and System Proficiency:
   • Adhere to HIPAA, Ohio Medicaid, and Agency fiscal regulations, maintaining client confidentiality and ethical billing practices.
   • Utilize multiple systems (e.g. Netsmart, Great Plains, Etc.) for AR, cash posting, and reporting.

OTHER DUTIES:

1. Participate in ongoing professional development to enhance AR and denial management skills.
2. Attend all required meetings, including staff, supervision, and revenue cycle sessions.
3. Perform additional duties as assigned by the AR Manager, such as supporting special projects or system enhancements.
4. Uphold client privacy, handling all client-related information per Agency confidentiality guidelines. Comply with HIPAA, CMS, and Ohio Medicaid regulations, ensuring secure data handling and ethical billing practices.
5. Report errors transparently and resolve issues promptly, upholding Agency standards.
6. Adhere to Wingspan Care Groups Code of Conduct, modeling ethical behavior and maintaining client confidentiality.

Wingspan Care Group (Wingspan) is the not-for-profit parent company of Applewood Centers, Inc., Bellefaire Jewish Childrens Bureau, Bluestone Child & Adolescent Psychiatric Hospital, and Lifeworks. The mission of Wingspan is to provide organizational efficiencies at the operational, administrative, and fiscal levels for its subsidiary agencies so that they may focus on their respective missions. Wingspan is an Equal Opportunity Employer. Wingspans policy is not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (40 and over), disability, military status, genetic information, or any other basis protected by applicable federal, state, or local laws. Wingspan also prohibits harassment of applicants or employees based on any of these protected categories.

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