Role Description The Accounts Receivable Specialist is responsible for implementation and coordination of fiscal transactions in a timely and accurate manner. This includes: - Claims processing - Cash collection - Claims resolution - Resolving credit balances - EOM balancing - Monthly statements Responsible for pre-claim review to assure billing compliance as required by the company. Is accountable for complying with all policies, procedures, and regulations related to billing all Medicare, Medicaid, and other Third Party Payors. It is expected that all duties and responsibilities will be performed in a manner consistent with the Ministry’s Standards of Behavior (CARE; Compassion, Advocate, Respect, Excellence) and the core values of Mercy Health which are: Excellence, Human Dignity, Justice, Compassion, Sacredness of Life, and Service. All supervisors and above are expected to model the organizational mission and values through their daily actions, decision-making, and priority setting. They are also expected to develop, implement, and monitor short and long-range plans to meet or surpass standards consistent with the overall strategic plan. Qualifications - High School Diploma or GED - Preferred: 2 Year/Associate Degree in Accounting, Finance, or related field - Combination of post-secondary education and experience will be considered in lieu of degree Requirements - High School Diploma - One year experience in medical collections or professional billing required - Basic computer knowledge and ability to use standard office equipment - Basic MS Office software skills - Problem-solving skills related to account resolution - Ability to adapt to changing procedures and growing environment - Preferred: 1-3 years of relevant experience in medical collections or professional billing - Knowledge of claims review and analysis Benefits - Competitive pay, incentives, referral bonuses, and 403(b) with employer contributions (when eligible) - Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources, and discounts - Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders - Tuition assistance, professional development, and continuing education support - Benefits may vary based on the market and employment status

Role Description The Accounts Receivable Specialist is responsible for implementation and coordination of fiscal transactions in a timely and accurate manner. This includes: - Claims processing - Cash collection - Claims resolution - Resolving credit balances - EOM balancing - Monthly statements Responsible for pre-claim review to assure billing compliance as required by the company. Is accountable for complying with all policies, procedures, and regulations related to billing all Medicare, Medicaid, and other Third Party Payors. It is expected that all duties and responsibilities will be performed in a manner consistent with the Ministry’s Standards of Behavior (CARE; Compassion, Advocate, Respect, Excellence) and reflect the core values of Mercy Health: Excellence, Human Dignity, Justice, Compassion, Sacredness of Life, and Service. All supervisors and above are expected to model the organizational mission and values through their daily actions, decision making, and priority setting. They are also expected to develop, implement, and monitor short and long-range plans to meet or surpass standards consistent with the overall strategic plan. Qualifications - High School Diploma or GED - Preferred: 2 Year/Associate Degree in Accounting, Finance, or related field - Combination of post-secondary education and experience will be considered in lieu of degree Requirements - High School Diploma - One year experience in medical collections or professional billing required - Must demonstrate basic computer knowledge - Ability to use standard office equipment and basic MS Office software - Problem-solving skills related to account resolution - Adapt to changing procedures and growing environment - Preferred: 1-3 years of relevant experience in medical collections or professional billing - Knowledge of claims review and analysis Benefits - Competitive pay, incentives, referral bonuses, and 403(b) with employer contributions (when eligible) - Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources, and discounts - Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders - Tuition assistance, professional development, and continuing education support - Benefits may vary based on the market and employment status

• Deliver proactive coding education through newsletters, scorecards, and presentations, covering CPT (E&M, modifiers), ICD-10-CM, HCPCS, Risk Adjustment, payer requirements, and rejection resolutions • Lead onboarding and compliance training for all employed Physicians/APPs, including Locum Tenens, residents, and students, ensuring documentation accuracy from the start • Provide individualized documentation feedback by reviewing new clinician records and conducting spot checks, escalating non-coding issues to appropriate teams • Serve as the primary contact for coding inquiries, coordinating with internal teams to resolve complex issues such as NCCI bundling and high-complexity charge edits • Monitor Epic work queues (charge review, follow-up, claim edit) to ensure timely and accurate charge submissions and reduce claim denials • Collaborate across departments—including CMOs, Clinical Informatics, Risk Adjustment, and Population Health—to enhance documentation practices and system optimization • Participate in specialty and department meetings, identifying trends and delivering targeted education to improve coding and documentation accuracy • Refine Epic documentation tools, including templates, order entries, diagnosis lists, and SmartSets/SmartPhrases, to improve efficiency and accuracy • Ensure compliance with regulatory standards, including Medicare, Medicaid, and AHIMA’s Standards of Ethical Coding • Promote a culture of ethical coding and continuous improvement, supporting clinicians with timely updates, feedback, and education to ensure accurate reimbursement and compliance

Role Description The Onboarding Specialist is the primary contact for members as they transition to a CCA health plan. The Specialist contacts new members via telephonic outreach and identifies both the member's existing healthcare services that will continue and new service requests. The Specialist works to ensure that member needs are addressed through liaising with internal CCA providers and external healthcare providers. The Specialist also educates the member on health plan offerings and addresses members' questions or concerns. - Serves as the primary member contact and advocate until their care team is established, both through direct member outreach and inbound call support. - Leverages internal and external resources (such as claims, referrals, and pharmacy data) to identify accurate, successful contact information for unreachable or hard-to-reach members. - Orients new members to the value of CCA as their health plan, providing education, answering members’ questions, anticipating, and meeting member needs and concerns. - Documents members’ current healthcare services and new service requests. - Ensures members continue to receive current healthcare services as they transition to CCA through healthcare provider outreach and education. - Schedules new members’ initial nurse intake visits. - Utilizes communication skills such as motivational interviewing to gain agreement from members to participate in the onboarding process, persistently forging trusting relationships and engaging individuals not readily interested in connecting with CCA. - Utilizes established workflows and collaborates with internal and external stakeholders and healthcare providers. - Provides clinical care to members via telehealth technologies (video, chat, etc.) for clinically appropriate clinical care and care management services. - Performs any other job-related duties as requested. Qualifications - Bachelor's Degree or relevant experience in call center and/or Medicare/Medicaid plan required. - Equivalent years of relevant work experience may be accepted in lieu of required education. - Five (5) years of relevant experience required. - One (1) year working in outreach or in the community with individuals who have behavioral, medical, social, or interpersonal complexities impacting their lives required. - Experience working in a multi-cultural setting required. - Experience using motivational interviewing techniques in a professional setting required. - Experience identifying unmet healthcare needs and escalating to the appropriate individual preferred. - Experience with electronic medical record and care management systems strongly preferred. Requirements - Demonstrated understanding of the community served. - Familiarity with data entry and querying databases to identify key information about members. - Excellent communication skills, including the ability to convey information clearly telephonically and in a culturally sensitive manner. - Strong interpersonal and customer relation skills, including active listening skills, dependability, and responsiveness. - Compassionate, understanding, and patient. - Motivates, empowers, inspires, and collaborates with members while effectively establishing boundaries by clarifying roles, expectations, and deliverables. - Ability to develop and maintain positive working relationships with peers, supervisors, and other organizations. - Knowledge of some medical terminology preferred. - Ability to multitask and ensure all work is completed thoroughly and completely in a fast-paced environment with competing demands. - Basic computer skills. - Professional, comprehensive, clear documentation. - Familiarity with Microsoft Office programs: Outlook, Calendar, Word. - Willing to learn and utilize telehealth technologies (video, chat, etc.), when appropriate, for a variety of clinical care and care management services. Benefits - Compensation Range: $47,400.00 - $76,000.00. - In addition to base compensation, you may qualify for a bonus tied to company and individual performance. - We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Working Conditions - General office environment; may be required to sit or stand for extended periods of time. - Travel is not typically required. Licensure and Certification - None. Company Description This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.