Complex Denials Specialist - Accounts Receivable

2 days ago

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Savista

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

1001 - 5000

Description

• Ensure timely collection of outstanding healthcare insurance receivables • Verify/obtain eligibility and/or authorization from insurance carriers • Update patient demographics/insurance information • Research unpaid or denied claims • Monitor claims for missing information and authorization • Access client systems for payment data • Secure needed medical documentation • Maintain confidentiality of patient information

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 of DDE Medicare claim system • Intermediate Knowledge of government rules and regulations