AR Specialist 1
Savista
Invision
AR Specialist, Complex Denials
Savista
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $21 - $24 per year
Job Level
Mid-LevelSenior
Tech Stack
Invision
About the role
- 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 and/or written correspondence to secure payment of claims; reconsideration and appeal submission.
- Adhere to state and federal claim and appeal guidelines.
- Access client systems for payment, patient, claim and data info
- Follow 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
- Understand, follow, and maintain productivity and performance based role expectations
- Perform other related duties as required
Requirements
- 3-5 years of medical collections, denials and appeals experience
- Experience with all but not limited to the following denials and appeals- DRG downgrades, level of care, coding, medical necessity, experimental, bundling, noncovered, and no authorization.
- Advanced knowledge of ICD-10, CPT, HCPCS and NCCI
- Advanced knowledge of third-party billing guidelines
- Advanced knowledge of billing claim forms (UB04/1500)
- Advanced knowledge of payor contracts- commercial and government
- Advanced working knowledge of Microsoft Word and Excel
- Advanced knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.)
