AR Claims Specialist II
Position Title: AR Claims Specialist II
City: Toppenish
State/Territory: US-WA
Employment Duration: Full time
Offer Relocation: No
Excempt Status: Non-exempt
ID: 16502
Description:
Join our team as an AR Claims Specialist II at Central Administration in Toppenish, WA!
This role plays a key part in the revenue cycle by researching claim issues, resolving billing errors, and ensuring compliance with payer and regulatory requirements. The AR Claims Specialist II also serves as a subject‑matter resource for assigned payers and supports team training and process improvement efforts. The AR Claims Specialist contributes directly to the financial health of YVFWC by ensuring claims are processed correctly and reimbursed in a timely manner. Through diligent follow‑up, payer expertise, and collaboration with billing and revenue cycle partners, this role helps reduce denials, improve workflows, and support YVFWC’s mission
Be part of a healthcare organization that believes in making a difference beyond medical care! We've transformed into a leading community health center in the Pacific Northwest with 40+ clinics across Washington and Oregon. We offer a wide range of services such as medical, dental, pharmacy, orthodontia, nutritional counseling, autism screening, and behavioral health. Our holistic model also extends assistance to shelter, energy, weatherization, HIV and AIDS counseling, home visits, and mobile medical/dental clinics.
We invite you to explore our short clips, "WE are Yakima - WE are Family" and "YVFWC - And then we grew," for a glimpse into our dedication to our communities, health, and families!
Position Highlights:
1.0 FTE (40 hours per week)
$21.44-$26.27/hour DOE with the ability to go higher for highly experienced candidates
100% employer-paid health insurance, including medical, dental, vision, Rx, 24/7 telemedicine
Profit sharing & 403(b) retirement plan available
Generous PTO, 8 paid holidays, and much more!
What You’ll Do:
Process third‑party claims in a timely and accurate manner, resolving claim edits and resubmitting corrected claims as necessary
Provide required documentation in account notes and participate in developing standard texts for account documentation
Maintain Epic Claims work queues according to daily department standards and research causes of repeated errors, addressing solutions through feedback loop processes
Reconcile daily claim volume balances using information from Epic and claims clearinghouse reports
Actively works with intra‑department leadership to create compliant, automated processes within Epic and the claims clearinghouse
Actively stay abreast of all payor billing changes and requirements, becoming the subject‑matter expert for assigned payors
Responsible for informing revenue cycle counterparts of coding or other billing changes implemented by the assigned payor
Maintain daily balance logs of claims sent from the EMR to the clearinghouse to ensure all claim runs are balanced daily
Train new AR Claims staff when called upon
Uphold Medicare, Medicaid, and HIPAA compliance guidelines in relation to billing, collections, and PHI information
Participate in the development of claims education and procedure documentation
Maintain confidentiality of all patient demographic, medical, and financial information at all times
Perform other duties as assigned
Qualifications:
High School diploma or GED
3 years of previous medical billing with third party and Medicare/Medicaid experience required
Certified Revenue Cycle Representative (CRCR) certification required
Completion of HFMA courses Strategies to Prevent Claim Denials or Best Practice (Patient Centric) Revenue Cycle Overview within 180 days of hire
Experience with EPIC system and FQHC billing and/or coding preferred
Strong attention to detail, analytical skills, and ability to meet deadlines
Knowledge of medical and insurance terminology, CPT, ICD coding structures, and billing forms (UB, 1500)
Strong customer relations skills preferred
Knowledge of medical/dental terminology, data entry, and billing coding preferred
Knowledge of accounts receivable processes preferred
Maintain consistent performance and attendance standards
Strong written and verbal communication skills
Our Mission Statement
“Together we transform our communities through compassionate, individualized care, eliminating barriers to health and well-being.”
Our mission celebrates inclusivity. We are committed to equal-opportunity employment.
Visit our website at www.yvfwc.com to learn more about our organization!
Equal employment opportunity, including veterans and individuals with disabilities.
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