Complex Denials Accounts Receivable 2

Savista

29d•$18 - $22

About The Position

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). Savista partners with healthcare providers to improve their financial strength by implementing integrated spend management and revenue cycle solutions that help control cost, improve margins and cash flow, increase regulatory compliance, and optimize operational efficiency. The Medical Insurance Accounts Receivable Representative is responsible for ensuring the timely collection of outstanding government or commercial healthcare insurance receivables.

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.)

Nice To Haves

Intermediate knowledge of one or more of the following Patient accounting systems - EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts or Paragon
Intermediate of DDE Medicare claim system
Intermediate Knowledge of government rules and regulations

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
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