Senior AR Specialist - Healthcare Payer Collections

Savista; Elm (PA); On-site; USD 28,000 - 32,000; Full time

Job summary

Savista is seeking a Medical Insurance Accounts Receivable Specialist to ensure timely collection of outstanding government or commercial healthcare insurance receivables. The role involves eligibility checks, data updates, and researching denied claims across client systems.

Responsibilities include communicating with payers, reviewing EOBs, complying with HIPAA and other regulations, and supporting the company’s compliance program.

Qualifications

• Three years of healthcare insurance A/R follow-up experience.
• Experience with government or commercial payers.
• Experience reviewing EOBs and 1500 forms.
• Knowledge of AR practices and denial overturns.
• Three years of AR software experience.
• Experience navigating payer sites for appeals.
• Strong Excel data entry and documentation.
• Effective communication with payers.
• Ability to work with cross-functional teams.
• Meet productivity: 55 claims per date, 275 per week.

Responsibilities

• Verifies patient eligibility and authorization by searching payer sites or contacting carriers.
• Updates patient demographics and insurance information in systems.
• Researches unpaid or denied claims and statuses them accordingly.
• Monitors claims for missing information, authorization, and ICN/DCN numbers.
• Researches EOBs for payments or adjustments to resolve claims.
• Contacts payers by phone or written correspondence to obtain payment.
• Accesses client systems for payment and open claim data.
• Adheres to deadlines and notation protocols in systems.
• Secures required medical documentation for third-party carriers.
• Obtains billing guidelines and requirements from provider manuals.
• Writes appeal letters for technical appeals.
• Verifies accuracy of underpayments by reviewing contracts and data.
• Prepares claims for clinical audit processing if needed.
• Supports compliance program with HIPAA, FDA, and other laws.

Skills

Healthcare A/R

Microsoft Excel

Payer communications

Data entry

Education

High school diploma or GED

Tools

Meditech Expanse

Job description

Savista is seeking a Medical Insurance Accounts Receivable Specialist to ensure timely collection of outstanding government or commercial healthcare insurance receivables. The role involves eligibility checks, data updates, and researching denied claims across client systems.

Responsibilities include communicating with payers, reviewing EOBs, complying with HIPAA and other regulations, and supporting the company’s compliance program.