Accounts Receivables Specialist

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Savista

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Revenue Cycle Management • HIM • Patient Engagement • Revenue Integrity • Accounts Receivable Management

1001 - 5000

Description

• Responsible for the timely collection of outstanding government or commercial healthcare insurance receivables • 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 or written correspondence to secure payment of claims; reconsideration and appeal submission. • Access client systems for payment, patient, claim and data info • Follows 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 • Perform other related duties as required

Requirements

• 2-3 years of medical collections, denials and appeals experience • Experience with all but not limited to the following denials- DRG downgrades, level of care, coding, medical necessity • 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.) • Intermediate knowledge of one or more of the following Patient accounting systems - EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts or Paragon • Intermediate knowledge of DDE Medicare claim system • Intermediate knowledge of government rules and regulations