AR Specialist 2 – Complex Clinical Denials

🔥 14 minutes ago

🇺🇸 United States – Remote

💵 $17 - $23 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

💰 Accounts Receivable

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Savista

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1994

💼 Consulting

📦 Logistics

🏥 Healthcare

Consulting • Logistics • Healthcare

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 or obtain eligibility and authorization using payer websites, client eligibility systems, or telephone contact with insurance carriers/providers • Update patient demographics and insurance information in appropriate systems • Research and status unpaid or denied claims • Monitor claims for missing information, authorization, and control numbers (ICN/DCN) • Research EOBs for payments or adjustments to resolve claims • Contact payers by phone or written correspondence to secure claim payments and submit reconsiderations and appeals • Follow state and federal claim and appeal guidelines • Access client systems for payment, patient, claim, and data information • Follow prioritization guidelines, timely filing deadlines, and notation protocols • Secure required medical documentation from third-party insurance carriers • Maintain patient-information confidentiality in accordance with insurance collection guidelines and corporate policies • Meet productivity and performance expectations • Perform other related duties as required

🎯 Requirements

• 2-3 years of medical collections, denials and appeals experience • Experience with denials and appeals including DRG downgrades, level of care, coding, medical necessity, experimental, bundling, noncovered, and no authorization • 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, including EMR, claim scrubbers, and patient accounting systems • Preferred: Intermediate knowledge of one or more patient accounting systems, including EPIC, Athena, Experian-Claim Source, Collections Management, Cerner, STAR, Meditech Expanse, CPSI, Invision, PBAR, All Scripts, or Paragon • Preferred: Intermediate knowledge of DDE Medicare claim system • Preferred: Intermediate knowledge of government rules and regulations