Accounts Receivable Specialist, Level 2

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

📋 Description

• Verify or obtain patient eligibility and authorization for healthcare services by exploring payer websites, client eligibility systems, or by contacting insurance carriers and healthcare providers.

• Update patient demographics and insurance information in the relevant systems.

• Investigate and appropriately categorize unpaid or denied claims.

• Monitor claims for any missing information, authorization, and control numbers (ICN/DCN).

• Review EOBs for payments or adjustments to resolve claims.

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

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

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

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

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

• Compose appeal letters for technical appeals.

• Verify underpayments by analyzing contracts and claims data.

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

• Support Savista's Compliance Program by adhering to HIPAA, FDCPA, FCRA, and other applicable laws and procedures, participating in required training, reporting concerns or incidents, managing patient information in a HIPAA-compliant manner, and maintaining confidentiality.

⛳️ Requirements

• High school diploma or GED.

• A minimum of three years of experience in healthcare insurance accounts receivable follow-up, having worked with or for a hospital or hospital system, and engaging directly with government or commercial insurance payers.

• Proficiency in identifying billing errors and resubmitting claims, as well as following up on payment errors, low reimbursements, 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, denial overturns, and third-party payer billing and reimbursement procedures.

• A minimum of three years of experience with accounts receivable software.

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

• Proven ability to navigate Internet Explorer and Microsoft Office, including entering and sorting data in Microsoft Excel and utilizing company email and calendar tools.

• Demonstrated experience in effective communication with payers, comprehending complex information, and accurately recording the encounter.

• Capability to work efficiently with cross-functional teams to meet objectives.

• Proven track record of meeting performance targets.

• Productivity requirements are set at 55 claims per day, totaling 275 claims per week.

• Experience with Epic is required.

• Experience with both hospital (facility) and physician (pro-fee) A/R is preferred.

🏝️ Benefits

• Competitive compensation package.

• Comprehensive health, dental, and vision insurance.

• Opportunities for professional development and advancement.

• Supportive work environment with a focus on teamwork.

• Flexible work hours.