Accounts Receivable Specialist II
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Job Description
Savista healthcare revenue-cycle specialist recovering government and commercial insurance receivables remotely. Researching claims, resolving denials and underpayments, and securing timely payer reimbursement.
Responsibilities:
- Verify or obtain patient eligibility and authorization for healthcare services.
- Update patient demographics and insurance information in appropriate systems.
- Research and status unpaid or denied claims.
- Monitor claims for missing information, authorization, and control numbers.
- Research EOBs for payments or adjustments to resolve claims.
- Contact payers by phone or written correspondence to secure claim payments.
- Access client systems for payment, open-claim, and other resolution information.
- Follow prioritization, timely filing, and notation protocols.
- Secure medical documentation requested by third-party insurance carriers.
- Research provider billing manuals for billing guidelines and requirements.
- Write appeal letters for technical appeals.
- Verify underpayments by researching contracts and claims data.
- Prepare denied claims for clinical audit processing.
- Support Savista's Compliance Program and adhere to HIPAA, FDCPA, FCRA, and other applicable laws.
- Meet productivity requirements of 55 claims per date/275 claims per week.
Requirements:
- High school diploma or GED.
- At least three years of experience in healthcare insurance accounts receivable follow-up.
- Experience working with or for a hospital or hospital system.
- Experience working directly with government or commercial insurance payers.
- Experience identifying billing errors, resubmitting claims, and following up on payment errors, low reimbursement, and denials.
- Experience reviewing EOB and 1500 forms for accounts receivable 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 Medicare and Medicaid insurance background.
- Demonstrated ability to navigate Internet Explorer and Microsoft Office, 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 encounters.
- Ability to work effectively with cross-functional teams.
- Demonstrated ability to meet performance objectives.
- Experience with Epic required.
- Experience with both hospital (facility) and physician (pro-fee) accounts receivable preferred.
Benefits:
- Certified Great Place to Work 4 years in a row
- Remote work arrangement
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