Complex Denials HB Accounts Receivable 2

The Medical Insurance Accounts Receivable Representative is responsible for ensuring the timely collection of outstanding government or commercial healthcare insurance receivables. Essential Duties & Responsibilities 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 Contact 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 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 Perform other related duties as required Hospital Billing Complex AR specific workflow familiarity Minimum Requirements & Competencies 2-3 years of medical collections, complex denials and appeals experience Experience with all but not limited to 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 (e.g., EMR, Claim Scrubbers, Patient Accounting Systems, etc.) Preferred Requirements & Competencies Intermediate knowledge of one or more patient accounting systems (EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts or Paragon) Intermediate knowledge of DDE Medicare claim system Intermediate knowledge of government rules and regulations Salary Range: $20.00 to $23.00 per hour. Compensation may vary within this range based on geographic location, experience, certifications, and skills. SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class. #J-18808-Ljbffr