Lead AR

VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER•Richmond, VA

About The Position

At Capital Area Health Network, we are committed to more than just providing healthcare—we are dedicated to transforming lives through compassion, excellence, and purpose-driven service. As a valued member of our mission-focused medical team, you'll be part of a culture that fosters our CAHN Cares: Compassion—We treat every person with dignity and fairness, embracing all and ensuring no one is alienated or discriminated against. Accountability—We safeguard the confidentiality of our patients and staff and are transparent in reporting to stakeholders and the community. Reverence—We answer a higher call to serve, uplift those in need, and create a community rooted in mutual respect and shared humanity. Excellence—We are committed to continuous learning and professional development, ensuring the delivery of culturally responsive, high-quality care. Stewardship—We responsibly manage our resources to benefit both the organization and the community we serve. We offer comprehensive primary care, dental services, and behavioral health support to our patients, ensuring every individual receives the quality care they deserve, regardless of background or circumstance. Our mission is clear: To deliver effective, accessible, and culturally responsive care, education, and advocacy that promote health and quality of life. Discover a place where your work makes a difference. Discover Capital Area Health Network. JOB SUMMARY The Lead AR is responsible for overseeing and guiding the review of explanations of benefits (EOBs), denials, and open accounts receivable to ensure timely and accurate resolution. Working with limited supervision and in accordance with established policies, procedures, and regulatory requirements, this role provides high-level support to both internal and external customers of Capital Area Health Network. The Accounts Receivable Lead collaborates daily with team members and cross-functional departments, offering direction, mentorship, and escalation support to drive the resolution of outstanding balances, improve team performance, enhance the customer experience, and uphold corporate integrity and compliance.

Requirements

High school diploma or equivalent GED. CPB certification preferred.
A comprehensive understanding of insurance requirements and regulations, contract benefits, credit and collection procedures, financial assistance programs, as well as familiarity with medical terminology, is required. A minimum of two years' experience preferred, but will consider one year.
The job requires analytical and critical thinking ability to diagnose account issues and active listening skills to provide service excellence. In addition, the work requires demonstrated project and time management skills and an ability to work effectively over the phone and in a team environment.
Knowledge of insurance, coordination of benefits, and reimbursement policies,s including HMO/PPO, Medicare, Medicaid, and other commercial payers.
Familiarity with CPT and ICD-10 Coding.
Excellent written and verbal communication skills
Ability to meet deadlines
Proficient in Microsoft Office Suite
Detail- oriented
Strong ability to multitask

Responsibilities

Provides guidance and training to all staff in daily operations
Creates Revenue Cycle SOPs to implement standard processes.
Motivates staff and organizes the day-to-day activity of the department in accordance with the RCM.
Manages Unbilled Claims, researches, and resolves issues as appropriate.
Maintains current knowledge of payer and coding regulations and requirements.
Assist in maintaining departmental metrics.
Assist with Team audits.
Identifies opportunities for improvement and shares feedback with internal and external customers.
Lead Team meetings.
Review Credit accounts for patients and insurance,s reconciling as needed.
Manages special projects as assigned by RCM.
Audits all explanations of benefits to confirm appropriateness of patient responsibility to ensure correct registration, coding, payment/adjustment posting, and insurance processing of claims.
Processes remittance, payment, and other documentation, including scanning and submission of information according to Cahn’s policy and procedure.
Meets or exceeds departmental productivity standaconsistentlyasis.
Selects priorities and organizes work and time to meet them in order of importance.
Recognizes and researches problematic trends regarding non-payment in an effort to implement preventive measures to increase the velocity of cash collections.
Informs the Revenue Cycle Manager of consistent issues as they occur and makes recommendations to improve departmental quality outcomes.
Communicates any payor changes and updates to the Revenue Cycle Manager.
Participates as a team member by performing additional assignments not directly related to the job description when workload requires and as directed by management.
Maintains strictest confidentiality; adheres to all HIPAA guidelines and regulations.
Demonstrates attention to detail, initiative, and judgment.