Accounts Receivable Specialist 2

Responsibilities

• Verifies or obtains patient eligibility and/or authorization for healthcare services performed
• Updates patient demographics and/or insurance information in appropriate systems
• Counsels payers by phone or through written correspondence to secure payment of claims
• Accesses client systems for information regarding received payments, open claims and other data necessary to resolve claims
• Follows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems
• Sets up medical documentation as required or requested by third party insurance carriers
• Obtains billing guidelines and requirements by researching provider billing manuals
• Writes appeal letters for technical appeals
• Verifies accuracy of underpayments by researching contracts and claims data
• In the event of an authorization, coding, level of care and/or length of stay denial, prepares claims for clinical audit processing
• Supports Savista Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable to Savista business practices

Requirements

• A high school diploma or GED
• At least two years of experience in healthcare insurance accounts receivable follow up, working with or for a hospital/hospital system, working directly with government or commercial insurance payers
• Experience identifying billing errors and resubmitting claims as well as following up on payment errors, low reimbursement and denials
• Experience reviewing EOB and UB-04 forms to conduct A/R activities
• Knowledge of accounts receivable practices, medical business office procedures, coordination of benefit rules and denial overturns and third-party payer billing and reimbursement procedures and practices
• At least two years of experience with accounts receivable software
• Experience navigating payer sites for appeals/reconsiderations, benefits verification and online claims follow up
• Demonstrated ability to navigate Internet Explorer and Microsoft Office, including the ability to input and sort data in Microsoft Excel and use company email and calendar tools
• Demonstrated experience communicating effectively with payers, understanding complex information and accurately documenting the encounter
• Ability to work effectively with cross-functional teams to achieve goals
• Demonstrated ability to meet performance objectives

Preferred Skills

• Experience with Epic, Meditech, Cerner, Invision, Paragon, Soarian, Collections Management or STAR
• Experience working with or for a hospital/hospital system with more than 150 beds
• Experience with both hospital (facility) and physician (pro-fee) A/R

Pay

The compensation range is between $18 to $21.