Solaris Health

Accounts Receivable

• The Insurance Accounts Receivable Specialist I is responsible for performing entry-level insurance billing and follow-up tasks to support timely and accurate reimbursement.
• This includes submitting claims, reviewing basic denials, and conducting follow-up on outstanding balances under supervision.
• The role focuses on learning workflows, applying standard procedures, and escalating more complex issues as needed.
• Responsibilities include but are not limited to: 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.
• Perform other position-related duties as assigned.

Insurance Accounts Receivable Specialist I

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Insurance Accounts Receivable Specialist

Insurance

• Responsible for securing insurance authorizations for medical services to ensure timely patient care and accurate reimbursement
• Initiate and track insurance prior authorizations for scheduled procedures, imaging, and other medical services
• Verify insurance eligibility and benefits using payer portals or through direct contact with payers
• Accurately document authorization statuses in the electronic medical record (EMR) and Practice Management (PM) system
• Ensure all authorizations are obtained prior to the scheduled date of service to avoid delays or denials
• Work closely with the Manager/Supervisor and Team Lead of Financial Clearance to escalate urgent or complex authorization cases
• Support team objectives and contribute to departmental huddles and workflow optimization initiatives
• Participate in ongoing training and feedback sessions led by the Supervisor to enhance performance and process compliance
• Communicate with insurance carriers to gather necessary clinical documentation and follow up on pending requests
• Identify and report recurring payer issues or trends to the Supervisor for team-level resolution or escalation
• Inform patients of authorization status, potential delays, and what to expect if coverage issues arise
• Coordinate with patient estimation staff to ensure authorizations align with cost estimates and pre-service collections efforts
• Performs other position related duties as assigned

Insurance Authorization Specialist

IT Support

• The IT Specialist is responsible for providing direct service support to users for a wide variety of computing devices/peripherals as well as all IT related functions.
• Works autonomously fulfilling end user requests and resolving issues according to service and procedural standards.
• Typical responsibilities involve moves, adds, and changes for computer devices, access requests/set up, application support and responding to break/fix service requests.
• Required to participate in IT related projects as directed.
• Maintains computer networks between locations and/or care centers.
• Contributes to determining hardware and software specifications.
• Responsible for application testing and documentation of workflow.
• Provides user support and customer service to physicians and staff to resolve software and hardware issues.
• Responds to questions from callers and walk-ins; remotely assists physicians and staff with technology problems in offices.
• Communicates security information to all levels of the organization.
• Under supervision, administers information security software and controls.
• Follows standard Help Desk operation procedures; accurately logs all Help Desk contacts using tracking software for job tickets.