Savista

An end-to-end revenue cycle services provider serving healthcare organizations for over 30 years.

Accounts Receivable Specialist, Level 2

Accounts ReceivableAccounts ReceivableFull TimeRemoteTeam 1,001-5,000Since 1994H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

32 days ago

Salary

$18 - $20 / hour

High School3 yrs expEnglish

Job Description

• Verifies or obtains patient eligibility and/or authorization for healthcare services performed by searching payer web sites or client eligibility systems, or by conducting phone conversations with the insurance carrier or healthcare providers. • Updates patient demographics and/or insurance information in appropriate systems. • Conducts research and appropriately statuses unpaid or denied claims. • Monitors claims for missing information, authorization, and control numbers (ICN//DCN). • Research EOBs for payments or adjustments to resolve claims. • Contacts payers by phone or through written correspondence to secure payment of claims. • Accesses client systems for information regarding received payments, open claims and other data necessary to resolve claims. • Follows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems. • Secures medical documentation as required or requested by third party insurance carriers. • Obtains billing guidelines and requirements by researching provider billing manuals. • Writes appeal letters for technical appeals. • Verifies accuracy of underpayments by researching contracts and claims data. • In the event of an authorization, coding, level of care and/or length of stay denial, prepares claims for clinical audit processing. • Supports Savista Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable to Savista business practices.

Job Requirements

  • High school diploma or GED.
  • At least three years of experience in healthcare insurance accounts receivable follow up, working with or for a hospital/hospital system, working directly with government or commercial insurance payers.
  • Experience identifying billing errors and resubmitting claims as well as following up on payment errors, low reimbursement and denials.
  • Experience reviewing EOB and 1500 forms to conduct A/R activities.
  • Knowledge of accounts receivable practices, medical business office procedures, coordination of benefit rules and denial overturns and third-party payer billing and reimbursement procedures and practices.
  • At least three years of experience with accounts receivable software.
  • Experience navigating payer sites for appeals/reconsiderations, benefits verification and online claims follow up with Medicare and Medicaid insurance background.
  • Demonstrated ability to navigate Internet Explorer and Microsoft Office, including the ability to input and sort data in Microsoft Excel and use company email and calendar tools.
  • Demonstrated experience communicating effectively with payers, understanding complex information and accurately documenting the encounter.
  • Ability to work effectively with cross-functional teams to achieve goals.
  • Demonstrated ability to meet performance objectives. Productivity requirements are 55 claims per date/275 claims per week.
  • Experience with Epic - Required.
  • Experience with both hospital (facility) and physician (pro-fee) A/R.

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