Accounts Receivable Resolution Specialist (FT, Days)

What You'll Do:

The Accounts Resolution Specialist contributes to the financial viability of the organization by assuring that accounts have been properly billed and reimbursed. Responsibilities include 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.

This is a fully remote position in these states: AL, AR, AZ, CA, CO, CT, DC, FL, GA, IL, IN, KS, KY, LA, MD, ME, MI, MN, MT, NC, NJ, NY, OH, OR, PA, SC, TN, TX, VA, WA, WI

What You'll Bring:

• 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
• Must have flu shot or exemption requiring masking during company established flu season.

It would be great if you had:

• Bachelor’s degree in health care or related field
• 5 years of experience with physician and/or facility billing/auditing within a behavioral health environment

What We Offer:

Full-time only:

• Employees (and their families) are offered comprehensive health insurance, including Medical, Dental, Vision, Accident, Critical Illness, and Hospital Indemnity
• CHS pays for Basic Life, AD&D, Short and Long-Term Disability
• Voluntary Life insurance option for employees and their families
• Health Savings Accounts (with $1,000 to $2,000 employer contribution depending on plan)
• Flexible Spending Accounts (health care and dependent care)
• 401k company match after 6 months (50% of deferrals up to 6% of compensation)
• Generous PTO starting at 160 hours accrued annually and 12 recognized company holidays
• Company‑paid parental leave available to eligible employees

All employees (Pool, Part-time and Full-time):

• Employee Assistance Program to help with confidential emotional support, work life solutions, financial solutions, legal assistance, or online support
• After 90 days, you are auto enrolled in the 401k Plan