Claims Representative Associate Jobs in Rhode Island

Job Summary
The Supervisor of TPC and CCBHC Revenue Cycle is an operational leader responsible for supporting the day-to-day revenue cycle functions for The Providence Center (TPC) and Certified Community Behavioral Health Clinic (CCBHC) services. This role focuses on ensuring timely billing, accurate follow-up, and resolution of accounts receivable, while supporting a high-touch, service-oriented model that requires significant manual intervention.While the overall accounts receivable volume may be smaller in dollar value, this role requires a high level of operational engagement, attention to detail, and coordination due to the complexity of workflows and manual processes. The Supervisor ensures claims are submitted accurately, works closely with staff on follow-up activities, and supports the resolution of denials, underpayments, and account discrepancies.This position plays a key role in maintaining strong relationships with internal teams, patients, and external partners by emphasizing responsiveness, customer service, and clear communication. The Supervisor also supports operational tasks across the revenue cycle, assists in workflow coordination, and helps identify opportunities to improve efficiency and performance within the TPC and CCBHC environment.The ideal candidate is a hands-on leader with strong analytical skills, the ability to manage multiple priorities, and a commitment to team support and service excellence. This role is less complex than enterprise-wide A/R leadership roles but requires a high level of engagement in daily operations and staff support.
Duties & Responsibilities

• Supervise the daily operations of the Accounts Receivable (A/R) team, ensuring timely and accurate claim submission, payment posting, follow-up, and resolution of outstanding
• Monitor aging reports, denial trends, overpayments and underpayments to ensure appropriate and timely follow-up with payers.
• Oversee workflows for insurance and/or patient A/R, including coordination with financial assistance staff and front-end teams to improve resolution and prevent delays.
• Ensure adherence to all federal, state, and payer regulations including CMS billing rules, HIPAA, and compliance policies.
• Support and participate in the implementation and optimization of the Epic system as it relates to A/R workflows and reporting.
• Identify, track, and analyze denial trends and underpayments; escalate systemic issues and collaborate with internal stakeholders for resolution.
• Maintain relationships with payer representatives to facilitate escalated claim resolution and stay informed of changes in payer policy.
• Serve as a liaison between the A/R team and other departments (e.g., Coding, Patient Access, Compliance) to address root causes of denials and ensure cross-functional
• Support patient-facing teams in resolving billing inquiries, providing financial guidance, and directing patients to appropriate financial assistance or payment plan resources.
• Collaborate with financial counselors and customer service representatives to ensure patient balances are addressed empathetically and effectively.
• Provide day-to-day supervision, support, and guidance to staff to maintain high levels of productivity, accuracy, and customer service.
• Conduct performance evaluations, identify training needs, and deliver coaching or corrective action as appropriate.
• Promote a culture of accountability, collaboration, and continuous improvement within the
• Foster employee engagement and professional development by encouraging ownership, transparency, and teamwork.
• Regularly communicate performance metrics, barriers to resolution, and key issues to the Director of A/R Management.
• Participate in A/R meetings and workgroups to review trends, monitor KPIs, and recommend operational improvements.
• Support audits, compliance reviews, and other external or internal reporting
• Evaluate existing workflows and recommend enhancements to reduce denials, increase collections, and improve the clean claim rate.
• Collaborate with Revenue Cycle leadership to support enterprise-wide initiatives and contribute to long-term strategy.
• Maintain strict confidentiality of patient information in compliance with HIPAA and organizational policies.
• Perform other related duties and responsibilities as assigned.

Requirements

• High School or GED Required; Associate's Degree Preferred
• Minimum 3 to 5 Years
• Revenue Cycle Knowledge (Behavioral Health Focus): Understanding of revenue cycle processes within behavioral health, outpatient, or community-based settings, including billing, collections, and accounts receivable follow-up.
• Claims and Payer Knowledge: Familiarity with payer requirements, authorization processes, and common denial scenarios. Ability to support staff in resolving routine claim and payment issues.
• Operational and Workflow Support: Ability to manage and support manual, high-touch workflows with a focus on accuracy, timeliness, and consistency.
• Customer Service Orientation: Strong interpersonal skills with a focus on patient and team support. Ability to handle inquiries with professionalism, empathy, and clarity.
• Analytical Skills: Ability to review basic reports, identify trends in denials or aging, and support problem-solving efforts to improve outcomes.
• Leadership & Team Support: Ability to supervise, guide, and support staff in daily operations. Emphasis on coaching, accessibility, and team engagement.
• Communication & Collaboration: Clear and effective communication with patients, staff, leadership, and external partners. Ability to escalate issues appropriately.
• Technical Proficiency: Familiarity with Microsoft Office and revenue cycle systems (e.g., Epic). Ability to navigate systems and support staff with basic reporting and workflows.
• Time Management & Multitasking: Ability to manage multiple priorities in a fast-paced, detail-oriented environment with a high degree of manual work.