Accounts Receivable Specialist 2 (PB)

Savista; United States; Remote; USD 26,000 - 29,000; Full time

Job summary

Savista, a healthcare-focused revenue cycle partner in the United States, seeks a Medical Insurance Accounts Receivable Specialist to ensure timely collection of government or commercial insurance receivables.

Responsibilities include verifying eligibility, updating records, researching denials, and contacting payers to secure payment. Collaboration with cross-functional teams and strong documentation are essential.

Qualifications

• At least three years of experience in healthcare insurance accounts receivable follow up.
• Experience identifying billing errors and resubmitting claims.
• Experience reviewing EOB and 1500 forms for A/R activities.

Responsibilities

• Verify patient eligibility/authorization via payer sites or outreach.
• Update patient demographics in systems.
• Research unpaid/denied claims and monitor status.
• Monitor claims for missing information and control numbers.
• Research EOBs for payments or adjustments.
• Contact payers to secure claim payments.
• Access client systems for payments and open claims data.
• Follow deadlines and notation protocols in systems.
• Secure required medical documentation for audits or appeals.
• Gather billing guidelines from provider manuals.
• Write appeal letters for technical appeals.
• Verify underpayments by reviewing contracts/claims data.
• Prepare claims for clinical audit processing when needed.
• Support compliance with HIPAA, FDCPA, FCRA and related laws.

Skills

A/R follow-up

Payer communications

EOB research

Denials analysis

HIPAA compliance

Microsoft Excel

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).

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.
• SupportsSavista Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable toSavista business practices. This includes becoming familiar withSavista’sCode of Ethics, attending training as required, notifying management orSavista 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 leastthree yearsof 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 leastthree yearsof 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.

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