Job Summary
The Accounts Receivable Specialist supports timely and accurate reimbursement for ERC programs by preparing and tracking third-party billing, posting payments, monitoring outstanding receivables, and assisting with claim and authorization issues. This position works closely with program staff, payers, and management to resolve billing barriers, maintain accurate records, and support compliance with HIPAA, state licensing requirements, payer requirements, and applicable ERC policies.
Supervisory Responsibility
None.
Essential Job Functions
- Prepare, enter, submit, and track third-party billing for assigned programs accurately and on time.
- Record accounts receivable and post payments in the accounting system; reconcile payment information as needed.
- Monitor accounts receivable aging and follow up on outstanding, delayed, or unpaid balances.
- Research rejected or denied claims, identify the cause, make or coordinate necessary corrections, and resubmit claims promptly.
- Work to ensure claims are complete and accurate before submission to reduce denials and payment delays.
- Communicate documentation or electronic medical record issues affecting billing to case managers or other appropriate program staff and follow through on resolution.
- Monitor payer and billing requirement changes and communicate relevant updates to management and affected staff.
- Work with government and private payer representatives to research claim status, resolve billing issues, and support timely payment.
- Provide management with clear, accurate billing and accounts receivable reports or data as requested.
- Assist program staff with prior authorization submissions and renewals, including correcting and resubmitting information when needed; this role supports the process rather than independently completing program-level authorizations.
- Identify recurring billing or denial trends and communicate opportunities to improve processes, documentation, and collections.
- Follow ERC procedures for approved adjustments and write-offs of uncollectible receivables.
- Maintain confidentiality and comply with HIPAA, payer requirements, state licensing requirements, and applicable ERC policies.
- Prioritize work with a sense of urgency to minimize the time between service delivery, claim submission, and payment.
Qualifications - Knowledge, Skills, and Abilities
- Strong attention to detail and commitment to accurate billing and recordkeeping.
- Ability to analyze billing data, identify patterns, research discrepancies, and solve problems.
- Working knowledge of accounts receivable processes, basic accounting principles, and financial chart of accounts.
- Ability to learn payer systems, billing requirements, and new processes and adapt to changes.
- Proficiency with computer systems and Microsoft Office Suite; ability to learn electronic medical record, payer portal, and accounting systems.
- Effective written and verbal communication skills and the ability to work professionally with employees, individuals served, vendors, and payer representatives.
- Ability to perform basic mathematical calculations accurately.
- Knowledge of HIPAA requirements and the ability to maintain confidential information.
Work Environment and Physical Demands
This position works primarily in a standard office environment and requires extended periods of computer and phone use. The role involves sitting, standing, walking, reaching, and other routine office activities. Occasional lifting or carrying of up to 50 pounds may be required. Moderate noise may occur at times.
Travel
Less than 10% local travel is expected.
Required Education and Experience
- High school diploma, GED, or equivalent.
- Two years of accounting, billing, accounts receivable, or related experience; an accounting certificate or associate degree may substitute for some experience.
- Proficiency in Microsoft Office Suite.
Preferred Education and Experience
- Postsecondary education in accounting, finance, business, or a related field.
- Three or more years of related billing, accounts receivable, or accounting experience.
- Experience with Medicaid, government payer, or private insurance billing.
- Knowledge of programs and services for individuals with intellectual and developmental disabilities.
- Experience in a nonprofit or human services organization.
- Experience supporting state licensure, payer reviews, or related audits.
Additional Eligibility Qualifications
- Must successfully complete required background checks.
- Must comply with applicable drug testing requirements.
- Reliable transportation is required.
- Must complete all training required for the position, including applicable licensure, health and safety, and HIPAA training.
Other Duties
Perform other duties as assigned to support ERC operations and fulfill the ERC mission. This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the position.
AAP/EEO Statement
The Elizabeth Richardson Center (ERC) is committed to equal employment opportunity and compliance with all applicable federal, state, and local laws prohibiting discrimination. ERC provides equal employment opportunities to qualified individuals without regard to any characteristic protected by applicable law and applies these principles throughout the employment relationship, including recruitment, hiring, placement, compensation, training, promotion, transfer, and separation.