Cape Cod Healthcare ยท 9 hours ago
Receivables Resolution Specialist (Remote Candidates Considered)
United States
Contract
Remote
Entry Level
$18.68/hr - $18.68/hr
1+ years expCape Cod Healthcare is seeking a Receivables Resolution Specialist to perform accurate and timely follow-up, reconciliation, and resolution of outstanding account balances. The role involves analyzing receivables, verifying payments, and collaborating with various departments to ensure effective account management.
Health Care
Responsibilities
Perform accurate and timely follow-up, reconciliation and resolution of outstanding account balances
Analyze and resolve outstanding receivables utilizing remittance reports, payment advisories, explanation of benefits, etc
Verify accuracy of third party payments
Post contractual allowances where necessary
Refer accounts for billing where appropriate, reassign eligible balances to self-pay and/or 3rd party billing status
Process third party payor denials and related correspondence in a timely and accurate manner
Perform administrative and clerical functions including but not limited to typing, photo copying, filing, calculating, faxing, etc., as assigned
Collaborate and interact with all departments to resolve edit errors
Maintain job knowledge adequate to effectively carry out the responsibilities of assigned insurance (s) group including CPT, HCPC, occurrence, condition, span and value codes in addition to modifiers
Maintain supporting documentation for all account changes with originating department sign-off
Pursue other insurance information through eligibility verification and check claims status utilizing online access and individual insurance carrier websites
Review billing, payment, and denial information utilizing a number of automated databases
Identifies potential reason(s) for payment denial, initiates and follows through with appropriate remedial action
Utilize third party denial management system to provide reports and workflow denials
Perform follow-up activities on unpaid accounts through downloaded trial balances, internet insurance websites, and other reports and/or claim listings where appropriate
Perform individual claim correction, adjustments, and cancels through online access to specific payors websites
Calculate patient liability and perform system adjustments to support accurate patient statement billing as needed
Respond to patient and/or insurer inquiries in a professional, timely, efficient and knowledgeable fashion, ensuring HIPAA and CCHC guidelines are followed
Monitor credit balance reports and performs analysis making appropriate claims adjustments and/or refunds as necessary
Create and maintain logs and reports as needed to support Patient Account activities
Assists the department and acts as a team member by covering for absences, training activities, etc., in support of hospital and departmental work activities
Comply with departmental and organizational policies including but not limited to dress code, use of supplies, phones and computers
Adheres to work schedules and maintains a safe and orderly work area at all times, maintaining awareness of and compliance with safety policies and procedures
Attends and participates in educational programs, in-service meetings, workshops, and other activities as related to job performance, job knowledge and state regulations
Ability to analyze automated computer output
Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers
Performs other job related duties and assignments as requested
Ability to read, write and communicate in English
Ability to work independently in a high paced and high demand environment or setting
Qualification
Required
Perform accurate and timely follow-up, reconciliation and resolution of outstanding account balances
Analyze and resolve outstanding receivables utilizing remittance reports, payment advisories, explanation of benefits, etc
Verify accuracy of third party payments
Post contractual allowances where necessary
Refer accounts for billing where appropriate, reassign eligible balances to self-pay and/or 3rd party billing status
Process third party payor denials and related correspondence in a timely and accurate manner
Perform administrative and clerical functions including but not limited to typing, photo copying, filing, calculating, faxing, etc., as assigned
Collaborate and interact with all departments to resolve edit errors
Maintain job knowledge adequate to effectively carry out the responsibilities of assigned insurance (s) group including CPT, HCPC, occurrence, condition, span and value codes in addition to modifiers
Maintain supporting documentation for all account changes with originating department sign-off
Pursue other insurance information through eligibility verification and check claims status utilizing online access and individual insurance carrier websites
Review billing, payment, and denial information utilizing a number of automated databases
Identifies potential reason(s) for payment denial, initiates and follows through with appropriate remedial action
Utilize third party denial management system to provide reports and workflow denials
Perform follow-up activities on unpaid accounts through downloaded trial balances, internet insurance websites, and other reports and/or claim listings where appropriate
Perform individual claim correction, adjustments, and cancels through online access to specific payors websites
Calculate patient liability and perform system adjustments to support accurate patient statement billing as needed
Respond to patient and/or insurer inquiries in a professional, timely, efficient and knowledgeable fashion, ensuring HIPAA and CCHC guidelines are followed
Monitor credit balance reports and performs analysis making appropriate claims adjustments and/or refunds as necessary
Create and maintain logs and reports as needed to support Patient Account activities
Assists the department and acts as a team member by covering for absences, training activities, etc., in support of hospital and departmental work activities
Comply with departmental and organizational policies including but not limited to dress code, use of supplies, phones and computers
Adheres to work schedules and maintains a safe and orderly work area at all times, maintaining awareness of and compliance with safety policies and procedures
Attends and participates in educational programs, in-service meetings, workshops, and other activities as related to job performance, job knowledge and state regulations
Ability to analyze automated computer output
Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers
Performs other job related duties and assignments as requested
Ability to read, write and communicate in English
Ability to work independently in a high paced and high demand environment or setting
High School diploma or GED required
12 months experience in accounts receivable, third-party medical billing or revenue cycle OR successful passage of the Patient Financial Services Qualifying Test
Successful passage of basic Medical Terminology course OR successful passage of the CCHC Medical Terminology exam
PC skills, including Microsoft Excel, Word and Outlook
Preferred
Experience in a healthcare setting preferred; prior healthcare/hospital experience with knowledge of EPIC or other hospital patient accounting system preferred
Company
Cape Cod Healthcare
Cape Cod Healthcare offers a comprehensive array of medical services delivered by top-notch teams of healthcare providers.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Michael Lauf
President and CEO
Richard Silveria
Chief Financial Officer
Recent News
2025-09-10
Company data provided by crunchbase