Complex Denials, Accounts Receivable 2

🕒 March 3

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Savista

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1994

⚕️ Healthcare Insurance

Healthcare Insurance

Savista is a full-service revenue cycle management provider with over 30 years of experience in the healthcare industry. They support healthcare organizations in improving financial outcomes by offering services such as AR management, denial management, clinical documentation integrity, eligibility & enrollment, and HIM outsourcing. Savista works as an extension of healthcare teams to optimize processes and increase efficiency to ensure compliance and drive patient-centered service quality. The company has garnered recognition and industry accolades for its effective and quality solutions.

📋 Description

• 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, complex 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.)