Role Description
The Accounts Resolution Specialist contributes to the financial viability of the organization by assuring that accounts have been properly billed and reimbursed. Responsibilities include:
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Contacting the appropriate insurance company to secure and expedite payments through the follow-up and appeals resolution processes.
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Acting as a functional leader or reference source.
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Exercising discretion and good judgment in decision-making and representation of Connections Healthcare Solutions.
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Providing the link in communication between Connections Healthcare Solutions and the patient, insurance companies/third-party payers, and the provider of service or departmental staff.
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Performing functions at a complex level of implementation, analysis, and resolution.
Specific duties include:
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Following up on required daily accounts based on leadership assignments to reduce the A/R.
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Performing timely and accurate validation of denied claims and determining appropriate denial resolution, including but not limited to; authorization/retro authorization/precertification.
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Utilizing WAYSTAR to submit appeal letters and payer-required documentation on unpaid and underpaid claims.
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Prioritizing work to increase efficiency in the collections process.
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Documenting action taken toward account resolution within Avatar and WAYSTAR using standardized note format.
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Meeting productivity requirements as set within the department.
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Effectively communicating identified opportunities with leadership utilizing SBAR format.
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Following chain of command as defined through CHS leadership.
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Participating in coordinated departmental initiatives related to AR reduction.
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Taking initiative to troubleshoot technological issues and communicating to leadership according to department guidelines.
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Assisting billing with determining the proper disposition of or composing replies to incoming mail and other correspondence.
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Performing all other duties as assigned.
This is a fully remote position.
Qualifications
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High School diploma, GED, or international equivalent.
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2 years of insurance claims follow-up.
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2 years of claim denial management.
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5 years of experience within a physician and/or facility business office.
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1 year of experience working in a remote environment.
Requirements
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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 Companyβs exemption process prior to their start date as a condition of employment.
Benefits
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Full-time only: Employees (and their families) are offered comprehensive health insurance, including Medical, Dental, Vision, Accident, Critical Illness, and Hospital Indemnity.
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CHS pays for Basic Life, AD&D, Short and Long-Term Disability.
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Voluntary Life insurance option for employees and their families.
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Health Savings Accounts (with $1,000 to $2,000 employer contribution depending on plan).
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Flexible Spending Accounts (health care and dependent care).
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401k company match after 6 months (50% of deferrals up to 6% of compensation).
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Generous PTO starting at 160 hours accrued annually and 12 recognized company holidays.
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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.
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After 90 days, you are auto enrolled in the 401k Plan.
Company Description
Connections Health Solutions is a leading provider of immediate-access behavioral health crisis care. Our team combines medical and recovery-oriented treatment to stabilize individuals in crisis and connect them to community-based resources for ongoing recovery.
Founded by emergency room psychiatrists Dr. Chris Carson and Dr. Robert Williamson, our model is physician-led and data-driven, drawing upon more than 15 years of crisis care expertise. Recognized by SAMHSA and the National Council for Mental Wellbeing as a national best practice, weβve delivered invaluable treatment to hundreds of thousands of individuals facing crises.
Our values shape our decisions, define our culture, and foster continuous learning and growth:
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We accept people as they are, creating safe spaces where they feel valued and respected.
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We inspire hope by walking with people side-by-side, showing them grace and compassion.
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We act with intention, holding ourselves and each other accountable, and doing the right thing.
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We work as one team, trusting and supporting each other.
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We embrace change and innovation, striving to find better ways to fulfill our mission.
We are on a mission to change the face of behavioral health. Help us save lives and make a difference.