AR Specialist, Level 2

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

📋 Description

• Verify or secure patient eligibility and/or authorization for healthcare services.

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

• Investigate and accurately status unpaid or denied claims.

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

• Research Explanation of Benefits (EOBs) for payments or adjustments to resolve claims.

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

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

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

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

• 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 in instances of 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, ensuring compliant handling of patient information and confidentiality obligations.

⛳️ Requirements

• High school diploma or GED.

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

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

• Proficient in reviewing EOB and UB-04 forms to perform A/R activities.

• Knowledgeable in accounts receivable practices, medical business office procedures, coordination of benefit rules, denial overturns, and third-party payer billing and reimbursement procedures.

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

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

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

• Proven success working independently and within a team environment.

• Strong communication skills with payers, capable of understanding complex information and accurately documenting encounters.

• Ability to work efficiently with cross-functional teams to achieve goals.

• Demonstrated ability to meet performance objectives.

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

• Preferred: Experience working with or for a hospital/hospital system with over 250 beds.

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

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health, dental, and vision insurance.

• Retirement savings plan with employer matching.

• Opportunities for professional development and growth.

• Flexible work environment and supportive team culture.