AR Specialist, Level 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, or phone conversations with insurance carriers or healthcare providers.

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

• Research and appropriately status unpaid or denied claims.

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

• Investigate EOBs for payments or adjustments to resolve claims.

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

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

• 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.

• Draft appeal letters for technical appeals.

• Verify underpayments by analyzing contracts and claims data.

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

• Support the Savista Compliance Program by complying with HIPAA, FDCPA, FCRA, and other relevant laws, completing required training, reporting compliance concerns, 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, working with or for a hospital/hospital system, and directly with government or commercial insurance payers.

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

• Proficiency 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 using 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.

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

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

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

• Proven track record of meeting performance objectives.

• Productivity requirements include processing 55 claims per day and 275 claims per week.

• Preferred: Experience with Athena EHR.

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

🏝️ Benefits

• Comprehensive health insurance options.

• Competitive salary and performance-based incentives.

• Opportunities for professional development and training.

• Flexible work schedule to promote work-life balance.

• Retirement savings plan with company match.