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About the job

Title: Accounts Receivable Specialist

Reports to: Director, Patient Financial Services Classification: Individual Contributor Location: Boston (Remote)

Job description revision number and date: V3.0; 9.9.25

Organization Summary:

Community Care Cooperative (C3) is a 501(c)(3) non-proﬁt multi-service organization governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We fulﬁll two primary business functions for the FQHCs we work with. First, we are an FQHC-led accountable care organization (ACO); second, we are a Management Services Organization (MSO) for FQHCs.

As an ACO, we negotiate value-based payor contracts on behalf of our FQHCs, hold and operate those contracts (including fulﬁlling many compliance, ﬁnancial management, and population health management functions), and maximize the return to FQHCs of any incentive dollars earned. We are proud to be the market leader in the MassHealth ACO Program. We are the largest Medicaid ACO in Massachusetts, and we operate a variety of business oﬀerings nationwide.

As an MSO, we (along with our subsidiary companies, which are also FQHC-led non-proﬁts) provide several ﬁnancial, operational, and technological services to groups of FQHCs. These services include Epic EHR licensing and implementation; pharmacy operations consulting as well as the building and direct operation of on-site retail pharmacies; billing and credentialing; employer-sponsored insurance; and others.

We are a fast-growing, dynamic organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.

Job Summary:

We are seeking an experienced Accounts Receivable Specialist to join our revenue cycle team. The

ideal candidate will have a strong background in professional billing or working in a doctor's office, with a preference for experience in Federally Qualified Health Centers (FQHC). The position requires a

detail-oriented and collaborative professional responsible for the implementation, configuration,

optimization, and support of Epic’s Resolute Professional Billing (PB) module. This role ensures accurate and efficient billing workflows, charge capture, claims processing, and reimbursement across the healthcare revenue cycle. Familiarity with Massachusetts healthcare regulations, electronic health records (EHRs), and related software is essential for success in this role.

Responsibilities:

Enter and review charges for accuracy, ensuring proper coding and compliance with payer requirements

Utilize the charge router within Epic to route charges efficiently and accurately to the correct claim workflows

Identify and resolve charge capture errors or discrepancies to prevent billing delays

Prepare, review, and submit electronic and paper claims through Epic and various clearinghouses, ensuring compliance with FQHC billing guidelines and Massachusetts-specific regulations

Apply claim form logic to review and resolve formatting errors before submission

Liaise with insurance companies to resolve discrepancies, missing files, and claim rejections

Analyze claim form logic, including UB-04 and CMS-1500 formats, to ensure proper billing practices are followed

Monitor claims for timely submissions by working closely with follow-up colleagues to address rejected or denied claims

Assist in managing accounts receivable by identifying trends in denials or delays

Perform payer appeals on denied claims as needed

Leverage Epic systems and other EHRs to support billing workflows, payment posting, and reporting

Reconcile daily payment batches to ensure all funds are accounted for and discrepancies are resolved promptly

Monitor unapplied payments and resolve posting errors in a timely manner

Work with banking institutions to ensure accurate deposit processing and address returned or rejected transactions

Function as a point of contact for inquiries related to payment posting and ERA processes

Generate and analyze payment posting and cash reconciliation reports to identify trends and areas for improvement

Maintain and update patient accounts and payer information in the system as needed

Collaborate with IT and billing teams to address system-related issues impacting billing processes

Ensure billing practices comply with FQHC-specific guidelines, Massachusetts healthcare regulations, and payer rules

Stay updated on changes to coding guidelines, billing codes, payer policies, and industry best practices

Participate in internal and external audits as required

Partner with clinical, coding, and health information teams to resolve billing documentation issues

Communicate effectively with insurance companies, patients, and other stakeholders to address billing inquiries

Review billing dashboards as a tool to monitor performance metrics and identify denial trends

Provide feedback to leadership on areas for improvement within billing workflows

Communicate effectively with insurance payers, patients, and internal teams to resolve billing and payment issues

Provide excellent customer service when assisting with account inquiries or payment concerns.

Other duties as assigned

Required Skills:

Knowledgeable of Massachusetts healthcare billing regulations and payer requirements

Minimum of 3-5 years of experience in medical billing, preferably in an FQHC or professional billing setting

Proficiency in Epic resolute professional billing processes

Strong understanding of claim form logic and payer-specific billing requirements

Familiarity with Massachusetts healthcare regulations and insurance processes

Knowledge of medical coding (CPT, ICD-10, HCPCS) and compliance requirements

Excellent attention to detail, organizational skills, and the ability to meet deadlines

Strong communication and problem-solving skills

Solid communication skills across stakeholders, diligence, and problem-solving skills

Experience in Microsoft Office Suite

Must have a strong commitment to quality assurance and exceptional customer service.

A strong commitment to C3’s mission

Desired Other Skills:

Familiarity with the MassHealth ACO program

Familiarity working in Federally Qualified Health Centers (FQHC)

Experience with anti-racism activities, and/or lived experience with racism is highly preferred

Qualifications:

High school diploma or equivalent required; associate or bachelor’s degree in business, healthcare administration, or a related field is preferred