Accounts Receivable Specialist II

This is a fully remote position, open to applicants in United States.

📋 Description

• Confirm or acquire patient eligibility and/or authorization for healthcare services utilizing payer websites, client eligibility systems, phone discussions with insurance carriers, or healthcare providers.

• Update patient demographic details and insurance information in the relevant systems.

• Investigate and appropriately categorize unpaid or denied claims.

• Track claims for missing details, authorization, and control numbers (ICN/DCN).

• Analyze EOBs for payments or adjustments to resolve claims.

• Reach out to payers via phone or written communication to secure payments for claims.

• Access client systems for received payments, open claims, and other necessary data to resolve claims.

• Adhere to prioritization, timely filing deadlines, and documentation protocols.

• Acquire medical documentation requested by third-party insurance carriers.

• Research provider billing manuals to gather billing guidelines and requirements.

• Draft appeal letters for technical appeals.

• Verify underpayments by analyzing contracts and claims data.

• Prepare claims for clinical audit processing regarding authorization, coding, level-of-care, or length-of-stay denials.

• Support Savista's Compliance Program by adhering to HIPAA, FDCPA, FCRA, and other relevant laws; manage patient information in a HIPAA-compliant manner while maintaining confidentiality.

⛳️ Requirements

• High school diploma or GED.

• Minimum of two years of experience in healthcare insurance accounts receivable follow-up, working with or for a hospital/hospital system, directly engaging with government or commercial insurance payers.

• Experience in identifying billing discrepancies and resubmitting claims, as well as following up on payment issues, low reimbursements, and denials.

• Familiarity with reviewing EOB and UB-04 forms to conduct accounts receivable activities.

• Knowledge of accounts receivable practices, medical business office procedures, coordination of benefits rules, denial overturns, and third-party payer billing and reimbursement processes.

• At least two years of experience with accounts receivable software.

• Proficiency in navigating payer websites for appeals/reconsiderations, benefits verification, and online claims follow-up.

• Proven ability to navigate Internet Explorer and Microsoft Office, including data input and sorting in Microsoft Excel, as well as using company email and calendar tools.

• Demonstrated success in both independent and team-based environments.

• Proven experience in effectively communicating with payers, comprehending complex information, and accurately documenting encounters.

• Ability to collaborate efficiently with cross-functional teams to achieve objectives.

• Proven ability to meet performance targets.

🏝️ Benefits

• Comprehensive healthcare coverage.

• Competitive salary and performance-based bonuses.

• Opportunities for professional development and career growth.