Accounts Receivable Resolution Specialist
Connections Health Solutions
full-time
Posted on:
Location: Virginia • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- The AR Resolution Specialist contributes to the financial viability of the organization by assuring that accounts have been properly billed and reimbursed.
- Contacting the appropriate insurance company to secure and expedite payments through the follow-up and appeals resolution processes and acting as a functional leader or reference source.
- This position requires discretion and good judgment in decision-making and representation of Connections Healthcare Solutions.
- Work situations are varied and require extensive insurance billing, follow-up and appeal knowledge, and strong customer service skills.
- This position provides the link in communication between Connections Healthcare Solutions and the patient, insurance companies/third-party payers, and the provider of service or departmental staff.
- The AR Resolution Specialist performs these functions at a complex level of implementation, analysis, and resolution.
- Follows up on required daily accounts based on leadership assignments to reduce the A/R.
- Performs timely and accurate validation of denied claims and determines appropriate denial resolution, including but not limited to; authorization/retro authorization/precertification.
- Utilizes WAYSTAR to submit appeal letters and payer-required documentation on unpaid and underpaid claims.
- Prioritizes work to increase efficiency in the collections process.
- Documents action taken toward account resolution within Avatar and WAYSTAR using standardized note format.
- Meets productivity requirements as set within the department.
- Effectively communicates identified opportunities with leadership utilizing SBAR format.
- Follows chain of command as defined through CHS leadership.
- Participates in coordinated departmental initiatives related to AR reduction.
- Takes initiative to troubleshoot technological issues and communicates to leadership according to department guidelines.
- Assists billing with determining the proper disposition of or composing replies to incoming mail and other correspondence.
- Performs all other duties as assigned.
Requirements
- High School diploma, GED, or international equivalent
- 2 years of insurance claims follow-up
- 2 years of claim denial management
- 5 years of experience within a physician and/or facility business office
- 1 year of experience working in a remote environment
- The Company has a mandatory vaccination policy. All successful applicants must be fully vaccinated, including showing proper documentation, or otherwise be exempt pursuant to the Company’s exemption process prior to their start date as a condition of employment
- It would be great if you had: Bachelor’s degree in health care or related field
- It would be great if you had: 5 years of experience with physician and/or facility billing/auditing within a behavioral health environment