Medical AR Specialist II: Claims & Denials Expert

Savista; Pennsylvania; On-site; USD 23,000 - 32,000; Full time

Job summary

Savista seeks an experienced Medical Insurance Accounts Receivable Representative in Pennsylvania to ensure timely collection of government or commercial healthcare insurance receivables. You will verify eligibility, update records, research denied claims, and communicate with payers to secure payments, while following guidelines and maintaining patient confidentiality.

The role emphasizes handling denials, appeals, and complex billing rules, requiring strong familiarity with ICD-10/CPT,

Qualifications

• 2–3 years of medical collections, denials and appeals experience.
• Experience with denials and appeals: DRG downgrades, level of care, coding, medical necessity, and related issues.
• Intermediate knowledge of ICD-10, CPT, HCPCS and NCCI.
• Intermediate knowledge of third-party billing guidelines.
• Intermediate knowledge of UB04/1500 claim forms.
• Intermediate knowledge of payor contracts (commercial and government).
• Proficiency with Microsoft Word and Excel; experience with health information systems.

Responsibilities

• Verify eligibility and obtain authorizations via payer sites or calls.
• Update demographics and insurance information in client systems.
• Research unpaid or denied claims and monitor for missing information.
• Review EOBs for payments or adjustments to resolve claims.
• Contact payers to secure payment, reconsideration, or appeals submission.
• Adhere to state and federal claim and appeal guidelines.
• Access client systems for payment, patient, claim and data info.
• Follow prioritization and timely filing deadlines in systems.
• Secure required medical documentation requested by third-party carriers.
• Maintain confidentiality of patient information per policies and guidelines.
• Understand and meet productivity and performance expectations.
• Perform other related duties as required.

Skills

Medical collections

Denials & appeals

ICD-10/CPT knowledge

Payor contracting knowledge

MS Word & Excel

Health information systems

Tools

EMR systems

UB04/1500 forms

Job description

Savista seeks an experienced Medical Insurance Accounts Receivable Representative in Pennsylvania to ensure timely collection of government or commercial healthcare insurance receivables. You will verify eligibility, update records, research denied claims, and communicate with payers to secure payments, while following guidelines and maintaining patient confidentiality.

The role emphasizes handling denials, appeals, and complex billing rules, requiring strong familiarity with ICD-10/CPT,