Solaris Health Holdings LLC

Compensation

Full Description

Description: We offer competitive pay as well as PTO, Holiday pay, and comprehensive benefits package! Benefits: • Health insurance • Dental insurance • Vision insurance • Life Insurance • Pet Insurance • Health savings account • Paid sick time • Paid time off • Paid holidays • Profit sharing • Retirement plan GENERAL SUMMARY The Clearinghouse Implementation and Rejections Manager is responsible for ensuring that the clearinghouse is effectively integrated with the practice management systems, customizing its features to fit the organizations workflow, and testing the system to ensure smooth operation. This plan aims to maximize the clearinghouse’s capabilities, which includes improving data accuracy and validation, streamlining claims submission, and enhancing compliance with regulatory standards. By implementing and training staff on the clearinghouse system, healthcare providers can submit and track claims more efficiently, reduce errors, and improve cash flow, ultimately leading to better financial outcomes and operational efficiency. Requirements: ESSENTIAL JOB FUNCTION/COMPETENCIES The responsibilities and duties described in this job description are intended to provide a general overview of the position. Duties may vary depending on the specific needs of the affiliate or location you are working at and/or state requirements. Responsibilities include but are not limited to: • Lead on the transition and conversion to Waystar as the chosen clearinghouse for the organization. • Complete enrollment process ensuring all necessary enrollment forms are completed for each payer including Medicare and Medicaid. • Lead, mentor, and manage a team of front line employees and the lead staff member to foster a culture of accountability, quality, and continuous improvement and employee engagement. • Train the team who will be working within the new clearinghouse while continuing to monitor the previous clearinghouse rejections. • Monitor and adjust during the transition as needed. • Analyze reports on clearinghouse rejections, denial trends, and error rates. Report this information to senior leadership, ensuring clear visibility of performance and areas of improvement. • Update master files within the PM system. • Develop and manage departmental goals, KPIs, and workflow efficiencies. • Manage staffing levels, hiring, onboarding, and performance evaluations for departmentl. • Supervise and mentor staff and team lead to ensure high levels of performance, engagement, and professional growth. • Collaborate with leadership and internal teams to streamline workflows, resolve high-impact issues, and ensure continuity between internal and external processes. • Lead initiatives to reduce denials and enhance payer relationships. • Performs other position related duties as assigned. • Employees shall adhere to high standards of ethical conduct and will comply with and assist in complying with all applicable laws and regulations. This will include and not be limited to following the Solaris Health Code of Conduct and all Solaris Health and Affiliated Practice policies and procedures; maintaining the confidentiality of patients' protected health information in compliance with the Health Insurance Portability and Accountability Act (HIPAA); immediately reporting any suspected concerns and/or violations to a supervisor and/or the Compliance Department; and the timely completion the Annual Compliance Training. CERTIFICATIONS, LICENSURES OR REGISTRY REQUIREMENTS • N/A KNOWLEDGE | SKILLS | ABILITIES • Excellent communication, leadership, and team management skills with the ability to collaborate across departments. • Strong problem-solving skills and attention to detail, with a focus on continuous improvement. • Excellent verbal and written communication skills. • Ability to work independently and manage deadlines. • Proficiency with Excel and other Microsoft Office products with ability to retrieve data, manipulate data and create useful analytical information. • Knowledge of budget preparation and planning. EDUCATION REQUIREMENTS • High School Diploma or equivalent required. • Associates level or higher preferred. EXPERIENCE REQUIREMENTS • Extensive experience with clearinghouse submissions • Minimum of five years’ revenue cycle management experience and claims submission within a physician practice. REQUIRED TRAVEL • N/A PHYSICAL DEMANDS Carrying Weight Frequency 1-25 lbs. Frequent from 34% to 66% 26-50 lbs. Occasionally from 2% to 33% Pushing/Pulling Frequency 1-25 lbs. Seldom, up to 2% 100 + lbs. Seldom, up to 2% Lifting - Height, Weight Frequency Floor to Chest, 1 -25 lbs. Occasional: from 2% to 33% Floor to Chest, 26-50 lbs. Seldom: up to 2% Floor to Waist, 1-25 lbs. Occasional: from 2% to 33% Floor to Waist, 26-50 lbs. Seldom: up to 2%