Offer summary

Qualifications:

2+ years of medical collections/billing experience, Intermediate knowledge of ICD-10, CPT, HCPCS, and NCCI, Working knowledge of Microsoft Word and Excel, Intermediate knowledge of health information systems..

Key responsabilities:

Ensure timely collection of outstanding healthcare insurance receivables

Verify patient eligibility and authorization for services

Conduct research on unpaid or denied claims and contact payers for resolution

Prepare claims for clinical audit processing and write appeal letters for technical appeals.

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 Accounts Receivable Specialist II 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).
Researches 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.
Supports Savista’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable to Savista’s business practices. This includes: becoming familiar with Savista’s Code of Ethics, attending training as required, notifying management or Savista’s Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations.

In addition:

Utilize provider billing manuals to obtain billing guidelines and requirements

Write appeal letters for technical appeals

Verifies accuracy of underpayments utilizing contracts and claims data

Prepares claims for clinical audit processing in the case of authorization, coding, level of care and/or length of stay denials

Minimum Requirements & Competencies:

2+ years of medical collections/billing 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

Working Knowledge of Microsoft Word and Excel

Intermediate working knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.)

Preferred Requirements & Competencies:

Working knowledge of one or more of the following Patient accounting systems - EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts, or Paragon

Working knowledge of DDE Medicare claim system

Knowledge of government rules and regulations

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 $18.00 to $20.00. 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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