Accounts Receivable Representative II

Savista; United States; Remote; USD 42,000 - 50,000; Full time

Job summary

Savista is seeking an Accounts Receivable Specialist II to ensure timely collection of government or commercial healthcare insurance receivables. This role involves eligibility checks, data updates, and proactive follow-up to resolve denials and ensure cash flow.

Responsibilities include researching EOBs, communicating with payers, and maintaining accurate patient records within client systems. Epic claims experience is preferred.

Qualifications

• High school diploma or GED required.
• At least two years in healthcare insurance accounts receivable follow-up.
• Experience with payer follow-up, denials, and resubmissions.
• Familiarity with EOBs, HCFCA forms, and AR processes.
• Proficient in Excel and email/calendar tools.

Responsibilities

• Verify eligibility/authorization by payer sites or calls.
• Update patient demographics and insurance data.
• Research and status unpaid or denied claims.
• Monitor claims for missing info and ICN/DCN.
• Research EOBs for payments or adjustments.
• Contact payers to secure payment of claims.
• Access client systems for payments/open claims data.
• Follow prioritization and filing deadline guidelines.
• Secure medical documentation as required.
• Obtain billing guidelines from provider manuals.
• Write appeal letters for technical/clinical appeals.
• Verify underpayments by researching contracts/claims.
• Prepare claims for clinical audit when needed.

Skills

Accounts receivable

Payer follow-up

Epic Physician claims

Excel

Communication with payers

Team collaboration

Education

High school diploma or GED

Tools

Accounts receivable software

Microsoft Excel

Epic

Job description

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

Job Summary

The Accounts Receivable Specialist II is responsible for ensuring the timely collection of outstanding government or commercial healthcare insurance receivables.

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).

• Researches EOBs for payments or adjustments to resolve claims.

• Contacts payers by phone or through written correspondence to secure payment of claims.

• Access 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 and clinical 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.

Requirements:

• High school diploma or GED.

• At leasttwo yearsof experience in healthcare insurance accounts receivable follow up, working with or for ahospital/hospital system, working directlywith 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 HCFCA 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 leasttwo yearsof 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 success working both individually and in a team environment.

• 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.

• Epic Physician claims experience

Note: Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $20.00 - $24.00 an hour. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills.

SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.

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