AR Specialist: Master Medical Claims & Denials

Savista, LLC; Alpharetta (GA); On-site; USD 28,000 - 32,000; Full time

Job summary

Savista, LLC in Alpharetta, GA is seeking a Medical Collections Specialist to verify eligibility, update patient data, and manage denied claims. You will monitor claims, research EOBs, and contact payers to secure payments while complying with regulatory guidelines.

Ideal candidates have 2–3 years in medical collections and strong familiarity with ICD-10, CPT, HCPCS, and NCCI; experience with EMR systems is a plus.

Qualifications

• 2-3 years of medical collections, denials and appeals experience.
• Intermediate knowledge of ICD-10, CPT, HCPCS and NCCI.
• Intermediate knowledge of third-party billing guidelines.
• Intermediate knowledge of billing claim forms (UB04/1500).
• Intermediate knowledge of payor contracts- commercial and government.
• Intermediate Working Knowledge of Microsoft Word and Excel.
• Intermediate knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.).

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

ICD-10 knowledge

CPT knowledge

HCPCS knowledge

NCCI knowledge

Tools

EPIC

Cerner

STAR

Meditech

CPSI

Paragon

Job description

Savista, LLC in Alpharetta, GA is seeking a Medical Collections Specialist to verify eligibility, update patient data, and manage denied claims. You will monitor claims, research EOBs, and contact payers to secure payments while complying with regulatory guidelines.

Ideal candidates have 2–3 years in medical collections and strong familiarity with ICD-10, CPT, HCPCS, and NCCI; experience with EMR systems is a plus.