Patient Account Receivables Specialist

Community Of Hope Inc.; Washington, Northern (District of Columbia, KY); Hybrid; USD 50,000 - 55,000; Full time

Benefits offered by this job

Top Washington Post Workplace

Eight-hour workdays with paid lunch

Vacation and holidays

Tuition reimbursement

Health, dental, vision insurance

403(b) retirement

Job summary

Community of Hope Inc. is seeking a Patient Account Receivable Specialist in Washington, DC. The role involves following up on outstanding claims, completing denials and appeals, and ensuring timely filing.

It is located at Conway Health and Resource Center in Southwest, DC, with remote/hybrid work options. Responsibilities include processing claims within 5 days, resolving eligibility issues, expediting adjudication, and documenting interactions in eCW.

Qualifications

• High School diploma required.
• Healthcare experience with Medicare and DC Medicaid preferred.
• 2 years minimum and 4+ years preferred in physician/dental/behavioral health billing.
• Confidentiality with PHI and employee data.
• Ability to meet strict deadlines and manage multiple tasks.
• Remote work with requirement to visit office bi-monthly.

Responsibilities

• Process claims within 5 days of the claim date to meet payer timely filing guidelines.
• Resolve eligibility issues and coding errors; ensure correct insurance placement and billing.
• Expedite adjudication by addressing denials and aging claims within 21 days.
• Document calls and actions in the practice management system (eCW).
• Handle complex denials by researching with insurers and patients as needed.
• Communicate with patients and insurers about COB, eligibility, and status.
• Generate refunds/voids per payer guidelines and respond to insurance correspondence within 5 business days.

Skills

Healthcare experience

Medicare

DC Medicaid

Physician billing

Dental billing

Behavioral health

MS Office

eClinicalWorks

Education

High School diploma

Tools

eClinicalWorks

Payer portals

MS Office

Job description

Description

Patient Account Receivable Specialists

Washington, DC | Remote | $24.03 - $26.44 per hour | Washington Post Top Workplace

Join Community of Hope as a Patient Account Receivable Specialist! in this role, you will follow up on outstanding claims in a timely manner according to the assigned inventory and follow-up guidelines. Complete denials and appeals within set guidelines and

Identify Insurance refunds and submits to Manager for review and approval. Join a mission-driven team dedicated to ending homelessness and making a meaningful impact every day. This position is located at Conway Health and Resource Center in Southwest, DC.

Our Approach and Values:

• We celebrate people’s strengths and acknowledge the impact of trauma on people’s lives.
• We embrace diversity, welcome all voices, and treat everyone with respect and compassion.
• We lead and advocate for changes to make systems more equitable.
• We strive for excellence and value integrity in all that we do

What You’ll Do

• Works claims to ensure billing is completed within 5 days of the claim date to stay within timely filing guidelines of each payer daily. Correcting errors to ensure claims are going out clean (check eligibility/demographics using payer web portals, checking modifiers, ICD 10 placement, converting claims, be sure insurance is checked and ensure correct placement of insurance i.e. primary, secondary, tertiary. Submits claims daily to ensure claims are billed in a timely manner so that claims are not adjusted off as timely filing on Board Write Off.
• Reviews and works the following status under Eligibility issues, pending, pending with errors, insurance accepted, insurance rejected, coding issues, all the HCFAs, mailed refund to payer, payment in route, wrap suspend. Claims should not be in that status code any longer than 10-14 days. Identifies patterns and addresses with Billing Manager.
• Able to expedite claim adjudication by resolving issues in ERA Denied, Rejections and other aged claims within 21 days since the claim placed in the above status code. Research errors and make necessary edits to claims that will make the claim ready for submission. If it involves the patient and/or guarantor, make contact by phone and/or letter 24-48 hours from issue being identified.
• Calls insurance companies daily and as needed, to determine when payments will be made and determines if any additional information is required to process adjudicated claims. Notates practice management software (eCW) stating the following: who was contacted, what was found, and how it was corrected.
• Handles complex denials by researching extensively and calling insurance, patients, and reviewing regulations daily and as needed. Contacts insurance to verify Coordination of Benefits (COB), eligibility, check timely filing and making sure the claim processes accurately.
• Contact the patient with the required number of contacts in order to resolve the patient’s demographics and/or insurance daily or as needed. (1. Call the patient, 2. Send Letter to patient 3.Email the patient if email is on file with limited information. 4.Send Action to PM 5. Call insurance to see if the issue is resolved. 6. Email the PM/EA). Coordination of Benefits will be placed on hold until directed to move forward.
• Reviews and proposes a minimum of 10 refunds/voids per week depending on payer guidelines. Refunds to be sent to the Billing Manager for approval and processing.
• Reviews and responds to all insurance correspondence within 5 business days of receipt or scanned in by Leaders. Urgent or time sensitive correspondence should be addressed within same business day of received if time permits, but at maximum the next business day, and coordinated with others on response as needed.

Requirements

Must-Haves

• High School diploma required.
• Healthcare experience with Medicare and DC Medicaid is strongly required/preferred.
• Minimum 2 years required and 4+ preferred experience in physician, dental and behavioral health business office environment, specifically in collection and billing.
• Maintains confidentiality in all matters that include Patient Health Information and employee data.
• Team player, highly organized and able to meet strict timely deadlines. Ability to prioritize and simultaneously manage all daily tasks.
• Ability to work in a fast-paced environment.
• Superior knowledge of computers including MS Office, Practice Management Systems (eClinicalWorks) payer’s website navigation and contract management.
• Able to perform basic and mathematical calculations, works credits on accounts and able to reconcile data.
• In relation to remote work versus on-site expectations, this position is classified as the following: Remote: A majority of the position may be able to work remotely, but employees will be required to report to the office a minimum of twice per month. Please note that remote work designations are subject to change or fluctuate at any point in time and the supervisor may require in person learning for a specific amount of time after hire.

Nice-to-Haves

• Some college studies or Associates degree preferred.
• Bilingual: Fluent in English and Spanish strongly preferred.

Why You’ll Love Working Here!

At COH, we prioritize the following well-being and work-life balance-centered benefits:

• 8 x Washington Post 150 Top Workplaces winner
• 8-hour workdays with paid lunch
• 3 weeks vacation (additional week after two years), 2 weeks sick leave, + 11.5 paid holidays and one personal floating holiday on an annual basis.
• Annual performance-based raises, up to 5% of your annual pay.
• Tuition reimbursement & loan repayment (NHSC & DCHPLRP), Licensing reimbursement & CEU funding.
• Medical, dental, vision, life & disability insurance + 403(b) retirement.
• Leadership development, internal promotions and career growth opportunities.
• A culture grounded in equity, compassion, and well-being.

About Us:

Community of Hope is a mission-driven, innovative, rapidly growing nonprofit, and Federally Qualified Health Center. For over 45 years, we have provided health and housing services, perinatal care coordination, and community support services to make Washington, DC more equitable. Community of Hope also strongly emphasizes maternal and child health, with midwifery practice and the only free-standing birth center in DC. We are honored to be one of DC’s largest providers of housing and homelessness prevention services for families and individuals throughout DC. Through our Family Success Center, our WIC nutrition centers, and our various partnerships, we have reached hundreds and believe that everyone in DC deserves to be healthy, housed, and hopeful. With the help of our amazing staff, we have successfully provided:

• 50,000+ medical visits
• 6,300+ dental visits
• 17,000+ emotional wellness visits
• 1,384 families and 220 individuals with housing/homelessness prevention services

Community of Hope is an equal opportunity employer.