AR Specialist II: Medical Collections & Appeals Pro

Savista, LLC; Northern (KY); Hybrid; USD 28,000 - 32,000; Full time

Job summary

Savista, LLC in Kentucky is seeking a medical billing specialist with 2–3 years of experience in medical collections, denials, and appeals to help secure payments and resolve claims. You will verify eligibility, update demographics, research unpaid or denied claims, and liaise with payers while adhering to guidelines.

Candidates should have working knowledge of ICD-10, CPT, HCPCS, NCCI, and third-party billing rules, plus familiarity with EMR and claim scrubbers.

Qualifications

• 2–3 years of medical collections, denials and appeals experience.
• Experience with DRG downgrades, level of care, coding, medical necessity, experimental, bundling, noncovered, and no authorization.

Responsibilities

• Verify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providers.
• Update patient demographics/insurance information in appropriate systems.
• Research/ Status unpaid or denied claims.
• Monitor claims for missing information, authorization, and control numbers (ICN//DCN).
• Research EOBs for payments or adjustments to resolve claim.
• Contacts payers via phone and/or written correspondence to secure payment of claims; reconsideration and appeal submission.
• Adhere to state and federal claim and appeal guidelines.
• Access client systems for payment, patient, claim and data info
• Follow guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems
• Secure needed medical documentation required or requested by third party insurance carriers
• Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure
• Understand, follow, and maintain productivity and performance based role expectations
• Perform other related duties as required

Skills

Medical collections

Denials & appeals

Payer negotiations

ICD-10/CPT/HCPCS

NCCI

EMR systems

Word & Excel

Health information systems

Tools

EPIC

Cerner

STAR

Meditech

CPSI

Invision

PBAR

All Scripts

Paragon

Job description

Savista, LLC in Kentucky is seeking a medical billing specialist with 2–3 years of experience in medical collections, denials, and appeals to help secure payments and resolve claims. You will verify eligibility, update demographics, research unpaid or denied claims, and liaise with payers while adhering to guidelines.

Candidates should have working knowledge of ICD-10, CPT, HCPCS, NCCI, and third-party billing rules, plus familiarity with EMR and claim scrubbers.