Accounts Receivable Resolution Specialist

The AR 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 role 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 reduces the A/R. Performs timely and accurate validation of denied claims and determines appropriate denial resolution, including 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.