Accounts Receivable Specialist II jobs in United States
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Savista · 3 hours ago

Accounts Receivable Specialist II

Savista is a company that partners with healthcare organizations to improve revenue cycles and patient experiences. The Medical Insurance Accounts Receivable Specialist is responsible for ensuring timely collection of outstanding healthcare insurance receivables and managing various accounts receivable tasks.

AccountingBillingHealth Care

Responsibilities

Verifies or obtains patient eligibility and/or authorization for healthcare services performed by searching payer web sites or client eligibility systems, or by conducting phone conversations with the insurance carrier or healthcare providers
Updates patient demographics and/or insurance information in appropriate systems
Conducts research and appropriately statuses unpaid or denied claims
Monitors claims for missing information, authorization, and control numbers (ICN//DCN)
Research EOBs for payments or adjustments to resolve claims
Contacts 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
Secures 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. This includes becoming familiar with Savista's Code of Ethics, attending training as required, notifying management or Savista Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations

Qualification

Healthcare insurance A/R experienceAccounts receivable softwareEOBUB-04 reviewBilling error identificationPayer site navigationMicrosoft ExcelMeeting performance objectivesHIPAA compliance knowledgeEffective communicationCross-functional teamworkAttention to detail

Required

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
Productivity requirements are 45 claims per date/225 claims per week

Preferred

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

Company

Savista

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Savista is a revenue cycle management that provides operational transformation services to acute and ambulatory facilities and systems.

Funding

Current Stage
Late Stage

Leadership Team

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Jan T. Grimm
Chief Executive Officer
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Company data provided by crunchbase