AR Specialist 2

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

📋 Description

• Verify or obtain patient eligibility and/or authorization for healthcare services through payer websites, client eligibility systems, phone conversations with insurance carriers, or healthcare providers.

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

• Investigate and appropriately status unpaid or denied claims.

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

• Research EOBs for payments or adjustments to resolve claims.

• Contact payers via phone or written correspondence to ensure payment of claims.

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

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

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

• Gather billing guidelines and requirements by researching provider billing manuals.

• Draft appeal letters for technical appeals.

• Verify underpayments by examining contracts and claims data.

• Prepare claims for clinical audit processing in cases of 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 and policies, including maintaining confidentiality and HIPAA-compliant handling of patient information.

⛳️ Requirements

• High school diploma or GED.

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

• Proven experience 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 procedures.

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

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

• Demonstrated proficiency in navigating Internet Explorer and Microsoft Office, including the ability to input and sort data in Microsoft Excel and utilize company email and calendar tools.

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

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

• Proven track record of meeting performance objectives.

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

• Preferred: Experience with Meditech Expanse.

• Preferred: Experience with Pennsylvania Insurance Processes - Medicaid.

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

🏝️ Benefits

• Comprehensive health insurance options.

• Retirement savings plan with employer matching.

• Generous paid time off and holiday schedule.

• Opportunities for professional development and training.