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AR Specialist, Level 2
Savista. Verify or obtain patient eligibility and/or authorization for healthcare services through payer websites, client eligibility systems, or phone conversations with insurance carriers or healthcare providers.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare insurance accounts receivable processes, including claims follow-up, billing error identification, and compliance with HIPAA regulations. Proficient in navigating payer websites and utilizing accounts receivable software to ensure timely and accurate claim resolutions.
Highest-signal resume keywords
Healthcare Insurance Accounts ReceivableClaims Follow-UpEOB ReviewAccounts Receivable SoftwareHIPAA Compliance
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ProcessingBilling Error IdentificationDenial ManagementMedical DocumentationData EntryClaims ResearchPayment ReconciliationTechnical Appeals WritingPayer Site NavigationCoordination of Benefits
Soft Skills
Effective CommunicationCross-Functional CollaborationProblem SolvingAttention to DetailTime Management
Tools & Technologies
Microsoft OfficeMicrosoft ExcelInternet ExplorerAthena EHR
Industry Keywords
MedicareMedicaidThird-Party PayerAccounts Receivable PracticesHealthcare ComplianceFDCPAFCRABilling ManualsPatient EligibilityAuthorization Processes
About the role
Key responsibilities & impact- Verify or obtain patient eligibility and/or authorization for healthcare services through payer websites, client eligibility systems, or phone conversations with insurance carriers or healthcare providers.
- Update patient demographics and insurance information in appropriate systems.
- Research and appropriately 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.
- Access client systems for received payments, open claims, and other information necessary to resolve claims.
- Follow prioritization guidelines, timely filing deadlines, and notation protocols.
- Secure medical documentation requested by third-party insurance carriers.
- Obtain billing guidelines and requirements by researching provider billing manuals.
- Write appeal letters for technical appeals.
- Verify underpayments by researching contracts and claims data.
- Prepare claims for clinical audit processing for authorization, coding, level of care, or length of stay denials.
- Support the Savista Compliance Program by adhering to HIPAA, FDCPA, FCRA, and other applicable laws, completing required training, reporting compliance concerns, handling patient information in a HIPAA-compliant manner, and maintaining confidentiality.
Requirements
What you’ll need- High school diploma or GED.
- At least three years of experience in healthcare insurance accounts receivable follow up, working with or for a hospital/hospital system, working directly with government or commercial insurance payers.
- Experience identifying billing errors and resubmitting claims as well as following up on payment errors, low reimbursement and denials.
- Experience reviewing EOB and 1500 forms to conduct A/R activities.
- Knowledge of accounts receivable practices, medical business office procedures, coordination of benefit rules and denial overturns and third-party payer billing and reimbursement procedures and practices.
- At least three years of experience with accounts receivable software.
- Experience navigating payer sites for appeals/reconsiderations, benefits verification and online claims follow up with Medicare and Medicaid insurance background.
- Demonstrated ability to navigate Internet Explorer and Microsoft Office, including the ability to input and sort data in Microsoft Excel and use company email and calendar tools.
- Demonstrated experience communicating effectively with payers, understanding complex information and accurately documenting the encounter.
- Ability to work effectively with cross-functional teams to achieve goals.
- Demonstrated ability to meet performance objectives.
- Productivity requirements are 55 claims per date/275 claims per week.
- Preferred: Experience with Athena EHR.
- Preferred: Experience with government payors; Medicare, Medicaid and Veterans Administration.