AR Claims Specialist I

AR Claims Specialist I

Join our team at YVFWC as an AR Claims Specialist I in Toppenish, WA! This role plays a key part in the revenue cycle by researching claim issues, resolving billing errors, and ensuring compliance with payer and regulatory requirements. The AR Claims Specialist also serves as a subject matter resource for assigned payers and supports team training and process improvement efforts. The AR Claims Specialist contributes directly to the financial health of YVFWC by ensuring claims are processed correctly and reimbursed in a timely manner. Through diligent follow-up, payer expertise, and collaboration with billing and revenue cycle partners, this role helps reduce denials, improve workflows, and support YVFWC's mission.

Be part of a healthcare organization that believes in making a difference beyond medical care! We've transformed into a leading community health center in the Pacific Northwest with 40+ clinics across Washington and Oregon. We offer a wide range of services such as medical, dental, pharmacy, orthodontia, nutritional counseling, autism screening, and behavioral health. Our holistic model also extends assistance to shelter, energy, weatherization, HIV and AIDS counseling, home visits, and mobile medical/dental clinics.

We invite you to explore our short clips, "WE are Yakima - WE are Family" and "YVFWC - And then we grew," for a glimpse into our dedication to our communities, health, and families!

Position Highlights:

• 1.0 FTE (40 hours per week)
• $19.76-$24.21/hour DOE with the ability to go higher for highly experienced candidates
• 100% employer-paid health insurance, including medical, dental, vision, Rx, 24/7 telemedicine
• Profit sharing & 403(b) retirement plan available
• Generous PTO, 8 paid holidays, and much more!

What You'll Do:

• Prepare and process insurance claims timely and accurately to government, commercial and managed care payers
• Review, submit and/or distribute corrected claims
• Enter appropriate account notes in Epic billing system to clarify actions taken to reconcile claims
• Resolve claim edits daily via claim edit work queues and/or our external billing software
• Verify eligibility for coverage via multiple payor websites
• Assure compliance with billing requirements for workers compensation and third-party liability claims
• Uphold Medicare, Medicaid, and HIPAA compliance guidelines in relation to billing, collections, and PHI information
• Maintain confidentiality of all patient demographics, medical and financial information at all times
• Maintains Epic Claims Work queues to department daily standard
• Maintain daily balance logs of claims sent from EMR to Clearinghouse daily to ensure all claim runs are balanced daily
• Perform other duties as assigned

Qualifications:

• High School diploma or GED
• Minimum six months' experience in healthcare setting
• Certified Revenue Cycle Representative (CRCR) preferred
• Experience with FQHC billing and/or coding preferred
• Strong attention to detail, analytical skills, and ability to meet deadlines
• Knowledge of medical and insurance terminology, CPT/ICD coding structures, and UB-04/1500 claim forms
• Strong written and verbal communication skills

Our Mission Statement

"Together we transform our communities through compassionate, individualized care, eliminating barriers to health and well-being."

Our mission celebrates inclusivity. We are committed to equal-opportunity employment.