Accounts Receivable Specialist II

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

📋 Description

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

• Update patient demographic data and insurance details in relevant systems.

• Investigate and provide status on unpaid or denied claims.

• Track claims for any missing information, authorization, and control numbers.

• Analyze EOBs for payments or adjustments to resolve claims.

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

• Access client systems for received payments, open claims, and associated information.

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

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

• Review provider billing manuals for billing guidelines and requirements.

• Draft appeal letters for technical appeals.

• Verify underpayments by analyzing contracts and claims data.

• Prepare denied claims for processing in clinical audits.

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

⛳️ Requirements

• High school diploma or GED.

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

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

• Experience directly dealing with government or commercial insurance payers.

• Proven ability to identify billing errors, resubmit claims, and follow up on payment discrepancies, low reimbursements, and denials.

• Experience reviewing EOB and UB-04 forms related to accounts receivable activities.

• Familiarity with accounts receivable practices and medical business office processes.

• Understanding of coordination of benefit rules, denial overturns, and billing and reimbursement procedures of third-party payers.

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

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

• Proficient in navigating Internet Explorer and Microsoft Office.

• Competent in inputting and sorting data in Microsoft Excel.

• Ability to effectively use company email and calendar tools.

• Proven ability to communicate effectively with payers, comprehend complex information, and accurately document encounters.

• Capability to work efficiently with cross-functional teams.

• Demonstrated ability to meet performance targets.

• Productivity requirement of 45 claims per day/225 claims per week.

• Preferred: Experience with Epic, Meditech, Cerner, Invision, Paragon, Soarian, Collections Management, or STAR.

• Preferred: Experience in a hospital or hospital system with over 150 beds.

• Preferred: Experience with both hospital facility and physician pro-fee accounts receivable.

🏝️ Benefits

• Remote work arrangement.

• Recognized as a Certified Great Place to Work.

• Training provided as necessary.

• Commitment to equal opportunity employment.