Patient Account Receivables Specialist

Patient Account Receivable Specialists

Are you excited about a new and exciting opportunity? Do you have a passion for working with families and individuals in need of healthcare, housing, and community support services? Are you interested in working for a mission-driven and innovative organization? Well, look no further! At Community of Hope, we envision Washington, DC, where everyone is healthy, housed, and hopeful. If you are ready to make a positive difference in the community, this position is for you!

Our mission: To improve health, end homelessness, and partner with communities to make Washington, DC more equitable.

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.

Position Summary:

The Patient Account Receivables Specialist is accountable directly to the Billing Lead. This is a full-time position, based out of Conway Health and Resource Center.

Salary – The salary range for this position is $24.03 - $26.44 per hour and the offer amount is determined by the candidate's education, qualifications, and experience. Indeed provides its own estimated salary calculator and is not affiliated with COH’s range.

Highlighted Duties and Responsibilities:

• 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.

• High School diploma required. Some college studies or Associates degree preferred.
• 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.

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

• Remote work opportunities are available for many, but not all, of our roles, promoting a culture of work-life balance.
• 8-hour workdays, which include a paid lunch
• 11.5 paid company holidays, 1 personal floating holiday, 15 days of paid vacation (increases to 20 after 3 years of service, 25 after 10 years of service, and 30 after 15 years of service), and 12 days of paid sick leave on an annual basis
• Annual performance-based raises, up to 5% of your annual pay
• National Health Service Corps (NHSC) and DC Health Professional Loan Repayment Program (DCHPLRP) participants
• Tuition reimbursement, loan repayment for clinicians, licensing reimbursement, and continuing education unit funds for licensed staff
• Many opportunities for internal promotions and transfers across the agency as we continue to grow; we average 30+ promotions each year
• Ongoing internal leadership training for supervisors
• Ongoing well-being activities, culture compact activities and training, and trauma-informed care initiatives and training
• Medical/Dental/Vision Plans through CareFirst BlueCross Blue Shield
• Life insurance, short-term disability, and long-term disability insurance
• 403(b) Retirement Plan
• Flexible Spending Accounts for medical and dependent care reimbursable expenses
• And much more!

About Us:

Community of Hope is a mission-driven, innovative, and rapidly growing nonprofit. For 45 years, we have provided healthcare, housing, and community support services to make Washington, DC more equitable. As a Federally Qualified Health Center, we provide medical, dental, emotional wellness, and care coordination services for the whole family at three locations in DC. Community of Hope also strongly emphasizes maternal and child health, with midwifery practice and the only free-standing birth center in DC. In 2024, Community of Hope provided about 50,000 medical visits, 6,300 dental visits, and 17,000 behavioral health visits for about 16,000 patients. Community of Hope is also one of the largest providers of homelessness prevention and housing services for 1,600 households—1,384 families and 220 individuals—experiencing homelessness in DC. Community support through Family Success Center, our WIC nutrition centers, and perinatal care coordination for pregnant people experiencing homelessness reach hundreds more families. We believe that everyone in DC can be healthy, housed, and hopeful.

We were selected as one of The Washington Post 150 Top Workplaces in 2024 and 6 other times since 2014 based on feedback from our staff.

To request a reasonable accommodation to complete an employment application or for general questions about employment with Community of Hope, contact a Recruiting Coordinator. Email: hr@cohdc.org Phone: 202-407-7747. Community of Hope is an equal opportunity employer.