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Savista

Savista is on a mission to help clients in healthcare navigate challenges by delivering revenue cycle management solutions. As an employer, the company strives to cultivate a colla

AR Specialist 2 – Complex Clinical Denials

Location

United States

Posted

14 days ago

Salary

$20 - $23 / hour

Seniority

Mid Level

2 yrs expEnglishInvision

Job Description

AR Specialist 2 – Complex Clinical Denials

Savista

• 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.

Job Requirements

  • 2-3 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.
  • 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.)
  • Preferred Requirements & Competencies Intermediate knowledge of one or more of the following Patient accounting systems: EPIC, Collections Management, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts or Paragon
  • Intermediate knowledge of DDE Medicare claim system
  • Intermediate knowledge of government rules and regulations.

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