Accounts Receivable Specialist 2 (PB)

Savista, LLC; Northern (KY); Hybrid; USD 26,000 - 29,000; Full time

Job summary

Savista, LLC in Kentucky seeks a Medical Insurance Accounts Receivable Specialist to support healthcare revenue cycle improvement services for our clients. You will verify patient eligibility and authorization, update demographics, track unpaid or denied claims, and secure timely payments by contacting payers.

The ideal candidate has at least three years of AR experience in hospital or hospital-system settings, familiarity with EOBs and 1500 forms, and proficiency with payer portals, Excel, and

Qualifications

• Three years of healthcare insurance accounts receivable follow-up experience.
• Experience with government or commercial payers.
• Experience reviewing EOBs and 1500 forms.

Responsibilities

• Verify patient eligibility and/or authorization for healthcare services by payer systems or phone.
• Update patient demographics and insurance information in systems.
• Research unpaid or denied claims and monitor for missing information or authorization.
• Contact payers to secure payment of claims and document interactions.
• Ensure compliance with HIPAA, FDCPA, FCRA and Savista policies.

Skills

Accounts receivable

Payer navigation

Excel

HIPAA compliance

Education

High school diploma or GED

Tools

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).

Medical Insurance Accounts Receivable Specialist

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.

Salary Range

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.

Equal Opportunity Employer

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.

Company Culture

The Savista experience is the combination of everything that’s unique about our culture, our core values, our commitment to success because of 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!