AR Specialist 2

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

📋 Description

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

• Revise patient demographics and insurance details in relevant systems.

• Investigate and properly status unpaid or denied claims.

• Oversee claims for missing details, 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 other data needed to resolve claims.

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

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

• Acquire billing guidelines and requirements through provider billing manuals.

• Compose appeal letters for technical appeals.

• Confirm underpayments by researching contracts and claims data.

• Prepare denied claims for clinical audit processing.

• Comply with Savista policies and procedures, including HIPAA, FDCPA, FCRA, confidentiality, and the Code of Ethics.

⛳️ Requirements

• High school diploma or GED.

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

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

• Experience in 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 processes.

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

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

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

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

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

• Proven ability to meet performance targets.

• Productivity requirements are 55 claims per day/275 claims per week.

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Retirement savings plan with company match.

• Paid time off and holidays.

• Opportunities for professional development and advancement.