Solaris Health

• Oversee patient accounts, verify and ensure the accuracy of accounts receivable (AR). • Contact patients to collect outstanding payments. • Research and resolve patient billing inquiries. • Accurately document all actions taken to reconcile outstanding balances. • Communicate with patients and insurance companies to resolve billing issues. • Ensure compliance with federal and state regulations. • Explain Care Credit to patients and encourage them to apply to resolve their balance in a timely manner. • Help patients create reasonable payment plans that suit their needs and support the financial health of facility. • Provide accurate customer service to patients and insurance companies. • Prepare specialized invoices and information as needed. • Prepare accurate files to send to the collection agency. • Verify patient demographics and update registration as required. • Perform other position related duties as assigned.

• The Radiation Oncology Coder Certified is responsible for successfully and efficiently coding all cases to the highest level of accuracy to ensure maximum reimbursement. • Ensure quality and productivity standards are met. • Ensure accurate coding of documentation to include diagnoses, procedures, and modifiers with adherence to established coding guidelines for both government and third-party payers. • Work with the Coding Supervisor to escalate coding issues and prevent untimely claim submission and denials. • Review chart documentation for accuracy and completeness, identify inconsistencies, and work with appropriate staff to resolve issues. • Communicate with Claims Resolution Specialists and Business Office staff to resolve errors and clarify issues. • Demonstrate in-depth knowledge of CPT, HCPCS, modifiers, diagnosis codes, insurance coverage plans, medical terminology, and anatomy and physiology. • Collaborate with providers to obtain complete documentation to support coding. • Stay accountable to quality and productivity standards and monitor compliance with policies and procedures. • Identify process opportunity trends and recommend ways to improve efficiencies. • Maintain current knowledge of coding guidelines and relevant state and federal regulations. • Ensure adherence to third party and governmental regulations relating to coding, documentation, compliance, and reimbursement. • Participate in special projects and personal development training as instructed. • Inform Coding Supervisor of trends, inconsistencies, discrepancies, or payer changes for immediate resolution. • Collaborate with peers and functional areas of the Coding and Revenue Integrity department for the betterment of tasks and the company overall.

• Define and execute the enterprise data governance roadmap, aligning with organizational and technology strategy. • Drive adoption of governance standards across business and clinical domains, ensuring enterprise-wide compliance and accountability. • Serve as the executive-facing leader for data governance, providing updates, metrics, and risk visibility to senior leadership. • Ensure that data is accurate, reliable, and maintained to high standards throughout its lifecycle. • Harmonize conflicting data sources and centralize them into a consolidated source of truth to improve data trust and accuracy. • Lead and mentor the data management team, facilitating communications across multiple committees, and engaging with data consumers to build a community that supports governance practices and policies. • Perform data analytics to examine and interpret raw data, answering questions, and finding trends to improve customer relations and organizational efficiency. • Perform data engineering responsibilities as necessary to support or enhance the results of the data engineering team. • Act as the organization's data security and compliance expert, ensuring that data practices adhere to internal policies and external regulations.

• Verify insurance coverage and benefit information using payer portals, clearinghouses, and direct communication with insurers. • Confirm plan status, effective dates, co-pays, deductibles, coinsurance, and authorization requirements. • Accurately document verification results in the EHR and/or PM. • Submit prior authorization requests for services, tests, and procedures based on payer requirements. • Monitor and follow up on pending authorizations to avoid delays in patient care. • Address denied or delayed authorizations with payers and escalate unresolved issues to the Supervisor as needed. • Coordinate with clinical staff to gather and submit necessary documentation for authorization approval. • Notify appropriate teams of coverage issues, authorization status, or patient financial risk. • Communicate with patients regarding their insurance coverage, financial responsibilities, and authorization outcomes when appropriate. • Collaborate with schedulers and front-desk teams to ensure appointments align with insurance requirements. • Follow standardized workflows and documentation protocols as outlined by the Supervisor. • Maintain accuracy and timeliness in all financial clearance documentation. • Participate in daily team huddles and contribute to process improvement initiatives.

• Focuses on supervising all activities related to credit balance and overpayment recovery • Responsible for identifying, analyzing, and resolving credit balances and overpayments • Provides direct supervision and daily management of claims resolution activities • Ensures timely escalation, resolution, and prevention of issues

• Handle complex claim scenarios • Resolve out-of-network claims • Review and write appeals • Assist with training and mentorship of staff • Serve as a resource for team members • Perform billing-related tasks including data entry, claim and charge review • Manage a greater volume and complexity of work • Identify and escalate payer issues • Follow standard workflows and proactively seek further education • Review reports to identify revenue opportunities

• 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.

• Oversee patient accounts, verify and ensure the accuracy of accounts receivable (AR). • Contact patients to collect outstanding payments. • Research and resolve patient billing inquiries. • Accurately document all actions taken to reconcile outstanding balances. • Communicate with patients and insurance companies to resolve billing issues. • Ensure compliance with federal and state regulations. • Explain Care Credit to patients and encourage them to apply to resolve their balance in a timely manner. • Help patients create reasonable payment plans that suit their needs and support the financial health of facility. • Provide accurate customer service to patients and insurance companies. • Prepare specialized invoices and information as needed. • Prepare accurate files to send to the collection agency. • Verify patient demographics and update registration as required. • Performs other position related duties as assigned.

• 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. • Performs other position related duties as assigned.

• Responsible for performing entry-level insurance billing and follow-up tasks to support timely and accurate reimbursement. • Includes submitting claims, reviewing basic denials, and conducting follow-up on outstanding balances under supervision. • Focuses on learning workflows, applying standard procedures, and escalating more complex issues as needed. • 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. • Effectively make system corrections and resubmit claims as necessary to meet payer requirements.