Accounts Receivable

• Perform billing-related tasks including data entry, claim review, charge review, and accounts receivable follow-up.
• Resolve high-complexity insurance accounts including denials related to medical necessity, non-covered services, bundling, and out-of-network claims (OON).
• Manage higher volume and complexity of work compared to Levels I and II while meeting productivity standards.
• Complete daily tasks in assigned work queues according to established workflows and manager direction.
• Utilize CBO Pathways, payer websites, billing systems, and training materials to resolve unpaid or incorrectly paid claims and authorize procedures.
• Identify and escalate payer issues, credentialing discrepancies, or coding concerns to management.
• Review reports to identify revenue opportunities and outstanding claims requiring follow-up.
• Adhere to departmental workflows, regulatory requirements, FGP compliance, and patient confidentiality guidelines (HIPAA).
• Communicate with patients, providers, coders, and other stakeholders to ensure accurate and timely claims processing.
• Provide insight and feedback on system edits, billing processes, and procedural improvements.
• Make corrections to system records to meet payer requirements and resubmit claims.
• Train and mentor new hires and provide guidance to team members as needed.
• Review and write appeals and assist staff in resolving complex claim or appeal-related questions.
• Perform other position-related duties and comply with Solaris Health Code of Conduct and annual compliance training.

Insurance Accounts Receivable Specialist III

Accounts Receivable Specialist

Account Receivable Analyst II

Accounts Receivable, Expense Management Specialist

Accounts Receivable Representative

Oracle Fusion Accounts Receivable Lead