Savista
An end-to-end revenue cycle services provider serving healthcare organizations for over 30 years.
Accounts Receivable Specialist II
Location
United States
Posted
11 hours ago
Salary
$18 - $21 / hour
High School2 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 two 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 UB-04 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 two years of experience with accounts receivable software.
- Experience navigating payer sites for appeals/reconsiderations, benefits verification and online claims follow up.
- 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 45 claims per date/225 claims per week.