Insurance Collections Specialist
Gastro Health
Accounts Receivable Specialist II
Savista
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $18 - $20 per hour
Job Level
JuniorMid-Level
About the role
- 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.
Requirements
- High school diploma or GED.
- At least two years of experience in healthcare insurance accounts receivable follow up, working with or for a hospital/hospital system, working directly with government or commercial insurance payers.
- Experience identifying billing errors and resubmitting claims as well as following up on payment errors, low reimbursement and denials.
- Experience reviewing EOB and UB-04 forms to conduct A/R activities.
- Knowledge of accounts receivable practices, medical business office procedures, coordination of benefit rules and denial overturns and third-party payer billing and reimbursement procedures and practices.
- At least two years of experience with accounts receivable software.
- Experience navigating payer sites for appeals/reconsiderations, benefits verification and online claims follow up.
- Demonstrated ability to navigate Internet Explorer and Microsoft Office, including the ability to input and sort data in Microsoft Excel and use company email and calendar tools.
- Demonstrated success working both individually and in a team environment.
- Demonstrated experience communicating effectively with payers, understanding complex information and accurately documenting the encounter.
- Ability to work effectively with cross-functional teams to achieve goals.
- Demonstrated ability to meet performance objectives.
