Accounts Receivable Specialist 2 (PB)

Savista, LLC; North Carolina; Hybrid; USD 26,000 - 29,000; Full time

Job summary

Savista, LLC in North Carolina is seeking a Medical Insurance Accounts Receivable Specialist to ensure timely collection of government and commercial insurance receivables. You will verify eligibility, update demographics, research denied claims, and communicate with payers to secure payments.

The role requires 3+ years in healthcare AR follow-up, familiarity with EOBs and 1500 forms, and experience navigating payer sites and AR software. Emphasis on accuracy and HIPAA compliance.

Qualifications

• Minimum of three years in healthcare insurance AR follow-up.
• Experience evaluating EOBs and processing denials.
• Ability to verify patient eligibility and obtain authorizations.

Responsibilities

• Verify patient eligibility and obtain authorization as needed.
• Update patient demographics and insurance data in systems.
• Research unpaid or denied claims and monitor claim status.
• Contact payers to secure payment of claims.
• Prepare claims for clinical audits when required.
• Ensure compliance with HIPAA and other regulations.

Skills

Eligibility verification

Research denied claims

EOB review and payments research

Excel proficiency

Payer communications

Education

High school diploma or GED

Tools

Epic

Microsoft Excel

Healthcare AR software

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).

The Medical Insurance Accounts Receivable Specialist 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).
• 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.

Requirements:

• High school diploma or GED.
• At least three 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 1500 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 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, 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 55 claims per date/275 claims per week.

Preferred Skills:

• Experience with Epic - Required Experience with both hospital (facility) and physician (pro-fee) A/R.

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 $19.00 to $21.00. 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.

California Job Candidate Notice

The Savista experience is the combination of everything that’s unique about our culture, our core values, our commitment to success, but most importantly, it’s our people. Our colleagues are problem-solvers, flexible and agile trusted partners who believe in a culture based on service. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us a Certified Great Place to Work 4 years in a row!

It has come to our attention that there have been some bad actors using our company name to solicit personal information as part of a fraudulent hiring scam. Unfortunately, this is out of our control, but we want to make it clear that this behavior is unacceptable. All of our open roles are posted on our careers page. Should you apply for a role and be contacted by an employee of Savista, all of our interviews will be scheduled by someone with an @savistarcm.com email address and conducted over video call or in-person. We never ask you to provide personal information through other means, such as Telegram or social media platforms, as part of our interview or onboarding process.

Make sure to double check our website address; there is no period in our domain name other than ".com". Savista does not and will not ask you to share any personally identifiable information (such as bank account details, SSN, etc) by any other means than a secure platform. We recommend you do not share any sensitive information over the phone or email. If you are offered a position, Savista does not and will not ask for payment to ship equipment. Fraudulent hiring scams often also ask for financial information and may ask for “advances.” Savista does not ask for any financial commitment at any stage of the recruitment process. We have reported and flagged these job scams when we’ve seen them. We also encourage you to contact your state attorney general’s office to report any potential scams and also recommend you contact any recruiting website and/or social media platform that may have been involved as well to notify them. Savista has no responsibility for fraudulent offers and advises job candidates to follow the guidance provided.