Solaris Health

Customer Support

• Address patient billing inquiries
• Resolve concerns or discrepancies
• Collect outstanding balances for healthcare services
• Ensure compliance with federal and state regulations
• Communicate with patients and insurance companies to resolve billing issues

Patient Customer Service and Collection Specialist

Manager

• The Clearinghouse Implementation and Rejections Manager is responsible for ensuring that the clearinghouse is effectively integrated with the practice management systems.
• Customizing its features to fit the organizations workflow.
• Testing the system to ensure smooth operation.
• Lead on the transition and conversion to Waystar as the chosen clearinghouse.
• Complete enrollment process ensuring all necessary enrollment forms are completed for each payer including Medicare and Medicaid.
• Lead, mentor, and manage a team of front line employees.
• Train the team who will be working within the new clearinghouse while continuing to monitor the previous clearinghouse rejections.
• Analyze reports on clearinghouse rejections, denial trends, and error rates.

Clearinghouse Implementation and Rejections Manager

Accounts Receivable

• Perform billing-related tasks as assigned, including data entry, claim review, charge review, and accounts receivable follow-up.
• Focus on resolving entry-level insurance denials, such as those related to medical records, eligibility, and coordination of benefits (COB).
• Complete daily tasks within assigned work queues based on manager direction and established workflows.
• Utilize CBO Pathways, payer websites, billing systems, and training materials to determine appropriate actions for resolving unpaid or underpaid claims and authorizing procedures.
• Identify potential issues related to payer requirements, provider credentialing, or coding, and escalate to management as appropriate.
• Review reports to identify unpaid claims and potential revenue opportunities.
• Communicate effectively with providers, patients, coders, and other stakeholders to ensure accurate and timely claims processing.
• Adhere to departmental workflows, operational policies, compliance guidelines, and regulatory requirements, including FGP and patient confidentiality standards.
• Provide input on system edits, process improvements, policies, and billing procedures to support revenue cycle optimization.
• Participate in meetings and workgroups, complete all required training sessions, and actively seek additional training when needed.
• Read and apply policies and procedures to make informed decisions, coordinate functions with team members, and explain processes clearly to others.
• Make system corrections and resubmit claims as necessary to meet payer requirements.
• Performs other position-related duties as assigned.

Patient Customer Service and Collection Specialist

Clearinghouse Implementation and Rejections Manager

Insurance Accounts Receivable Specialist