Accounts Receivable Lead Claims Specialist

We are seeking an organized and results-driven Accounts Receivable Lead Claims Specialist to join our Business Office team. In this role, you will play a critical part in managing the accurate and timely submission of resident charges to appropriate payers, including Medicare/Medicaid, private insurance companies, and other third-party payers. You will manage and maintain an efficient system for tracking and organizing accounts, ensuring compliance with federal, state, and local billing regulations. Key responsibilities will include processing payer correspondence, verifying payment accuracy, and resolving discrepancies or denials to ensure timely reimbursement. You’ll also handle cash posting and adjustments, assist with Medicaid processes, and interpret Explanation of Benefits (EOB) remittances. The position requires consistent account follow-up and collections to ensure reimbursement is collected from all payer sources.Additionally, you’ll be responsible for verifying census data daily, facilitating claims reconsiderations and appeals, and maintaining clear communication with internal teams, residents, payers, and other stakeholders to ensure billing inquiries are addressed promptly and professionally. If you're focused, detail-oriented, and ready to bring your expertise in accounts receivable, billing, and claims management to a dedicated and hardworking team, we want to hear from you.  Location: Cedar Falls, IA (Regular in-office attendance is required) Schedule: Full-time Benefits of an Accounts Receivable Lead Claims Specialist: Health, Dental, & Vision Insurance Flexible PTO 401k Match Continuing Education Opportunities  Tuition and Student Loan Reimbursement Wellness Reimbursement Employee Assistance Program *Actual wage based on experience And much more! Requirements of an Accounts Receivable Lead Claims Specialist:   (Preferred) 2 year Accounting, Business, or Finance degree or equivalent (Preferred) Prior experience working with accounts receivable and accounting reports This role requires someone who can work quickly, efficiently, and under pressure to meet deadlines in a dynamic, fast-paced setting Prior experience working with accounts receivable and accounting reports Proven organizational abilities and time management skills Must be able to manage several projects simultaneously paying close attention to details Must be able to read, speak and write fluent English Experience using personal computers as well as proficiency in the utilization of a variety of software applications programs (Excel, Word, and Various Accounting Software systems) Effective oral and written communication skills   Responsibilities of an Accounts Receivable Lead Claims Specialist: Billing & Claims Submission: Prepare and submit accurate resident charges to Medicare/Medicaid, private insurance, and other payers in a timely manner. Account Management: Maintain an organized system for submitting and tracking resident charges to ensure accurate billing and compliance with all federal, state, and local regulations. Reimbursement Processing: Process payer correspondence, verify payment accuracy, and promptly resolve discrepancies or denials to ensure timely reimbursement. Cash Posting & Adjustments: Post cash receipts, manage necessary adjustments, and ensure accuracy across all payer sources. Medicaid Process Assistance: Support the application, continuation, and compliance of Medicaid processes for residents. Explanation of Benefits (EOB) Review: Interpret and process payer EOB remittances, applying necessary adjustments and submitting documentation for further posting by AR Manager. Account Follow-Up & Collections: Track and collect reimbursements due from all payer sources and follow up on unpaid accounts in accordance with collection procedures. Census Verification: Ensure daily verification of census data for accuracy in billing and reporting purposes. Claims Reconsideration & Appeals: Facilitate inquiries, reconsiderations, and appeals to payers for denied claims or adjustments. Team Collaboration & Communication: Maintain effective communication with residents, payers, fiscal intermediaries, and internal teams, ensuring timely and accurate response to all billing inquiries. If you feel like you, or someone you know, would be a good fit for this opportunity within Western Home Communities- we would love to talk!  Western Home Communities is a continuing care retirement community (CCRC). That means we offer residential living for seniors at every stage of health, activity and independence, from those who need no assistance, to others who require round-the-clock nursing care. This is often referred to as the continuum of care.   Mission Statement: Western Home Communities is a charitable Christian Service Organization that assertively creates fulfilling lifestyles for those we serve, their families and our employees.   The ideal candidate for this position supports the Western Home Communities values of people first, servant spirit, innovation and financial integrity. We offer an array of living options, care, and services for the well-being of our clients.  Join our team to make a difference in the lives of those we serve!   #WHC