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Savista · 4 hours ago

Complex Denials Accounts Receivable 2

United States

Full-time

Remote

Entry, Mid Level

$18/hr - $22/hr

2+ years exp

Savista is a company that partners with healthcare organizations to enhance their financial strength through integrated spend management and revenue cycle solutions. The Medical Insurance Accounts Receivable Representative is responsible for ensuring the timely collection of outstanding healthcare insurance receivables, including verifying eligibility, researching claims, and securing payments.

AccountingBillingHealth Care

Responsibilities

Verify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providers

Update patient demographics/insurance information in appropriate systems

Research/ Status unpaid or denied claims

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

Research EOBs for payments or adjustments to resolve claim

Contacts payers via phone or written correspondence to secure payment of claims; reconsideration and appeal submission

Access client systems for payment, patient, claim and data info

Follows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems

Secure needed medical documentation required or requested by third party insurance carriers

Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure

Perform other related duties as required

Qualification

Medical collectionsComplex denials experienceICD-10 knowledgeCPT knowledgeHCPCS knowledgeBilling claim formsHealth information systemsPatient accounting systemsMicrosoft WordMicrosoft ExcelDDE Medicare claim systemGovernment regulations knowledge

Required

2-3 years of medical collections, complex denials and appeals experience

Experience with all but not limited to the following denials- DRG downgrades, level of care, coding, medical necessity

Intermediate knowledge of ICD-10, CPT, HCPCS and NCCI

Intermediate knowledge of third party billing guidelines

Intermediate knowledge of billing claim forms(UB04/1500)

Intermediate knowledge of payor contracts- commercial and government

Intermediate Working Knowledge of Microsoft Word and Excel

Intermediate knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.)

Preferred

Intermediate knowledge of one or more of the following Patient accounting systems - EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts or Paragon

Intermediate of DDE Medicare claim system

Intermediate Knowledge of government rules and regulations