Accounts Receivable Specialist II

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

📋 Description

• Confirm or secure patient eligibility and authorization for healthcare services.

• Modify patient demographics and insurance details in the appropriate systems.

• Investigate and track unpaid or denied claims.

• Supervise claims for absent information, authorization, and control numbers.

• Examine EOBs for payments or adjustments to resolve claims.

• Communicate with payers via phone or written correspondence to ensure claim payments.

• Access client systems for payment, open-claim, and other resolution insights.

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

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

• Research provider billing manuals for billing guidelines and requirements.

• Compose appeal letters for technical appeals.

• Validate underpayments by examining contracts and claims data.

• Prepare denied claims for clinical audit processing.

• Support Savista's Compliance Program and comply with HIPAA, FDCPA, FCRA, and other relevant laws.

• Achieve productivity targets of 55 claims per day/275 claims per week.

⛳️ Requirements

• High school diploma or GED.

• Minimum of three years of experience in healthcare insurance accounts receivable follow-up.

• Experience working with or for a hospital or hospital system.

• Experience collaborating directly with government or commercial insurance payers.

• Proficient in identifying billing errors, resubmitting claims, and following up on payment discrepancies, low reimbursements, and denials.

• Familiarity with reviewing EOB and 1500 forms for accounts receivable activities.

• Knowledge of accounts receivable practices, medical business office protocols, coordination of benefit rules, denial reversals, and third-party payer billing and reimbursement procedures.

• At least three years of experience utilizing accounts receivable software.

• Experience navigating payer websites for appeals/reconsiderations, benefits verification, and online claims follow-up, specifically with Medicare and Medicaid.

• Proven ability to navigate Internet Explorer and Microsoft Office, input and organize data in Microsoft Excel, and utilize company email and calendar tools.

• Demonstrated experience in effective communication with payers, understanding complex information, and accurately documenting interactions.

• Ability to collaborate effectively with cross-functional teams.

• Proven capability to meet performance objectives.

• Experience with Epic is required.

• Preference for experience in both hospital (facility) and physician (pro-fee) accounts receivable.

🏝️ Benefits

• Certified Great Place to Work for four consecutive years.

• Remote work arrangement.