Accounts Receivable

• 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.

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