AR Billing Specialist bei CAMcare Health Corporation

CAMCARE HEALTH CORPORATION

Job Description

A/R Billing Specialist

Who We Are: 

CAMcare Health Corporation is a mission-driven Federally Qualified Health Center (FQHC) serving Camden and Gloucester counties. Our team is dedicated to delivering accessible, high-quality healthcare to all individuals regardless of their ability to pay. With seven health centers and a commitment to innovation, we are reimagining community health by embracing technology, equity, and compassion.

Position Summary

The A/R Billing Specialist is responsible for ensuring timely and accurate processing of claims and collections in accordance with FQHC, federal, and payer-specific guidelines. The specialist will play a key role in managing accounts receivable, resolving claim denials, and supporting billing compliance using the EPIC EHR system. This role contributes directly to CAMcare’s financial sustainability and compliance with Uniform Data System (UDS) and Medicaid/Medicare reporting standards.   This position will report to the Billing Supervisor. 

Key Responsibilities

• Submit primary and secondary claims electronically and by paper to government and commercial payers.
• Identify and resolve payment edit errors and rejections; escalate unresolved issues when appropriate.
• Utilize EPIC EHR and billing modules to verify charge entry, apply edits, track claim status, and process payments.
• Post payments and contractual adjustments from EOBs/EFTs/remittance advice accurately.
• Conduct follow-up on denied or underpaid claims and initiate appeals or resubmissions.
• Track OB delivery charges and obtain required authorization/GEMS numbers for billing.
• Assist in preparing UDS perinatal reports and data for federal reporting.
• Research and update Medicaid Pending claims with verified Medicaid IDs.
• Submit patient statements and maintain accurate account balances.
• Establish and monitor patient payment plans in line with sliding fee policies.
• Support collection efforts and coordinate write-offs, bad debt, or agency assignments.
• Collaborate across departments (e.g., Registration, Clinical, Compliance) to resolve billing discrepancies.
• Leverage payer portals to validate claims, coverage, and remittance data.
• Assist with audits, internal reviews, and revenue cycle improvement initiatives.
• Maintain billing compliance with FQHC-specific guidelines, CMS rules, and payer contracts.
• Provide backup assistance to team members and perform other duties as assigned.

Key Performance Indicators (KPIs)

• Claim First-Pass Rate (Clean Claim Rate): ≥ 95%
• Days in Accounts Receivable (A/R): ≤ 40 days average
• Claim Denial Rate: ≤ 5%
• Payment Posting Accuracy: ≥ 98%
• Timely Submission of Claims: ≥ 99% submitted within 5 days of service
• Denial Resolution Turnaround Time: ≤ 15 days from receipt
• Patient Collection Rate (Sliding Fee / Payment Plans): ≥ 85% compliance
• Timely OB Charge Entry & Authorization: 100% within 3 business days of delivery
• EPIC Work queue Resolution Rate: ≥ 95% cleared within 3 business days

What You Bring

Required:

• High School Diploma or GED.
• 1–2 years of experience in medical billing within a healthcare setting (FQHC preferred).
• Proficient in EPIC EHR, especially billing and claims processing modules.
• Knowledge of CMS, Medicaid, commercial billing rules and modifiers.
• Working knowledge of Microsoft Office (Excel, Outlook, Word).

Preferred:

• Medical Billing Certification (e.g., AAPC, AHIMA).
• Nationally recognized Coding Certification (if performing coding functions).
• Bilingual English/Spanish proficiency.
• Familiarity with Medicaid PPS, sliding fee schedules, and UDS reporting.

Core Competencies

• Exceptional attention to detail and data accuracy.
• Strong analytical, problem-solving, and time management skills.
• Ability to work independently and collaboratively in a fast-paced environment.
• Effective written and verbal communication.
• Understanding patient confidentiality and HIPAA requirements.
• Commitment to CAMcare’s mission, values, and equity-driven care model.

Working Conditions

• Standard office setting with potential for hybrid flexibility.
• Occasional travel to other CAMcare locations may be required for support or training.

CAMcare Health Corporation is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.