AR & Collections Specialist

Wage band range $23.50 - $36.00 hourly. However, starting pay is ultimately determined by the scope of the position, the candidate's relevant experience, and internal equity.

Carries out the mission of Casa Pacifica as it pertains to managing revenue and accounts receivable and is responsible for medical billing, verification of benefits (VOBs), and collections.  Works in a team environment under the direction of the Accounting Manager. The AR & Collections Specialist is responsible for ensuring that strong revenue recognition and collection principles, practices and procedures are implemented and maintained.

DUTIES AND RESPONSIBILITIES:

• Effectively manage collections of outstanding balances, working with insurance carriers and patients to ensure timely payments.
• Monitor and track claim status, following up with insurance carriers to ensure payments are received promptly.
• Troubleshoot and resolve billing issues, ensuring compliance with insurance guidelines.
• Implement strategies to reduce accounts receivable days and improve cash flow.
• Develop in-depth understanding of all aspects of medical billing, including submission of claims, payment posting, and reconciliation for private insurance.
• Conduct verification of benefits (VOBs) for patients, ensuring accurate insurance information is obtained.
• Maintain a strong understanding of commercial insurance carrier billing requirements, both in-network and out-of-network.
• Collaborate with the billing and clinical teams to ensure accurate coding and documentation.
• Stay current on healthcare billing regulations, coding changes, and compliance requirements.
• Ensure that billing practices align with federal and state regulations, as well as with the policies of 3^rd party payers.
• Generate and analyze reports related to billing performance, reimbursement rates, and other key financial metrics.
• Implement strategies to reduce accounts receivable days and improve cash flow.
• Collaborate closely with the Accounting Manager to facilitate revenue analysis and support audit processes, ensuring comprehensive coordination and alignment across the department.
• Work on special projects as assigned.

QUALIFICATIONS REQUIRED:

• 3 years of experience in medical billing, with a strong focus on private insurance. Experience in the mental health industry is highly desirable.
• Solid understanding of insurance billing practices, including both in-network and out-of-network carriers.
• Extensive experience with verification of benefits (VOBs), insurance authorizations and collections/ appeals / denials on delinquent accounts.
• Strong knowledge of medical coding, billing software, and revenue cycle management tools.
• Excellent communication and interpersonal skills, with the ability to interact effectively with patients, insurance carriers, and clinical staff.
• Strong problem-solving skills and the ability to handle complex billing issues.

EDUCATION and/or EXPERIENCE: Associate degree in Business or Finance or related field or equivalent experience in accounting environment. Minimum of three years of experience and in-depth knowledge of healthcare billing, coding, and collections.

LANGUAGE SKILLS: Ability to read and interpret documents such as insurance requirements, authorizations, and coverages, safety rules, operating and maintenance instructions, and procedure manuals.  Ability to write routine reports and correspondence.

COMMUNICATION SKILLS: Ability to respond to inquiries from internal and external stakeholders and third-party payers. Ability to write reports and business correspondence and procedure manuals. Ability to effectively present information and respond to questions from managers.

ANALYTICAL SKILLS: Strong analytical and problem-solving skills to identify and address billing issues promptly.  Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to work with and apply mathematical concepts.

ATTENTION TO DETAIL: Meticulous attention to detail to ensure accuracy in billing and coding.

OTHER SKILLS AND ABILITIES:  

• Advanced level Microsoft Excel expertise required.
• Proficiency in medical billing software and Electronic Health Record (EHR) systems.
• Experience in Avatar and REV Connect is highly desirable.
• Knowledge of healthcare billing processes, coding systems, regulatory requirements and familiarity with insurance claim processing and reimbursement methodologies.

Casa Pacifica Offers:

• Competitive Wages
• Comprehensive Benefits package, including 401k with up to 5% fully vested employer matching contributions made after first year of service
• Medical, Dental & Vision Insurance options
• Flexible Spending and Dependent care programs
• Excellent Training opportunities
• Education/Tuition Assistance programs
• Group Discount Pet Insurance
• Aflac Critical Illness, Accidental & Dental supplemental plan options
• Employee Assistance Program
  • Free Confidential Crisis Line 24/7 (365 days a year)
  • 4 face-to-face or telephonic sessions per issue, i.e.,
    • Stress, Anxiety, Depression
    • Life transitions
    • Grief and Loss
    • Divorce
    • Conflict Resolution
    • Substance Abuse
    • Work-Life Counseling
    • Free Legal and Financial Consultations
    • Identity Theft Recovery Services

Casa Pacifica restores hope, enhances resilience, and strengthens community connections for children, young adults, and families.

We are a diverse and inclusive team providing excellent services to all our communities. Our team members are empowered to share their identities, ideas, and perspectives. A culture built on diversity, equity and inclusivity is essential to creating a safe and healing environment at Casa Pacifica.

Casa Pacifica is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability. All applicants will be given full consideration under state, local, and federal law.

Salary : $24 - $36