AR Specialist – Level 2

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

📋 Description

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

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

• Investigate and accurately status unpaid or denied claims.

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

• Analyze EOBs for payments or adjustments to effectively resolve claims.

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

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

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

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

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

• Compose appeal letters for technical appeals.

• Verify the accuracy of underpayments by reviewing contracts and claims data.

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

• Support Savista's Compliance Program by following HIPAA, FDCPA, FCRA, and other relevant laws; participate in required training, report concerns or incidents, handle patient information in a HIPAA-compliant manner, and maintain confidentiality.

⛳️ Requirements

• High school diploma or GED.

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

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

• Familiarity with reviewing EOB and 1500 forms to carry out 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 practices.

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

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

• Proven ability to use Internet Explorer and Microsoft Office, including inputting and sorting data in Microsoft Excel, as well as utilizing company email and calendar tools.

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

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

• Demonstrated ability to achieve performance targets.

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

• Preferred: Experience with Athena EHR.

• Preferred: Experience with government payers including Medicare, Medicaid, and Veterans Administration.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health, dental, and vision insurance.

• Retirement savings plan with company match.

• Generous paid time off and holiday schedule.

• Continuing education and professional development opportunities.