Account Receivable Specialist II

Account Receivable Specialist II

locations Remote – USA

time type Full time

job requisition id R2037

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).

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
• Contacts payers via phone or written correspondence to secure payment of claims
• 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
• Utilize provider billing manuals to obtain billing guidelines and requirements
• Write appeal letters for technical appeals
• Verifies accuracy of underpayments utilizing contracts and claims data
• Prepares claims for clinical audit processing in the case of authorization, coding, level of care and/or length of stay denials
• Perform other related duties as required

Minimum Requirements & Competencies:

• 2+ years of medical collections/billing experience
• 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
• Working Knowledge of Microsoft Word and Excel
• Intermediate working knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.)

Preferred Requirements & Competencies:

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

Core Values and Culture Expectations

Demonstrates integrity and ethics in day-to-day tasks and decision making, adheres to nThrive’s core values of courage, authenticity, respect, excellence and service, operates effectively in the nThrive environment and the environment of the work group, maintains a focus on self-development and seeks out continuous feedback and learning opportunities.

Travel: Minimal

Physical Demands:

The physical demands and work environment characteristics described here are representative of those that an employee must meet to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is occasionally required to move around the work area; sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
• The employee must occasionally lift and/or move up to 15 pounds.
• Must be able to talk, listen and speak clearly on telephone.
• Mental Demands: the employee must be able to follow directions, to get along with others, and handle stress;
• Work environment: The noise level in the work environment is usually minimal.
• Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.
• Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards.